Faculty Collaboration Database

Primary treatment of nasolacrimal duct obstruction with nasolacrimal duct intubation in children younger than 4 years of age. J AAPOS 2008 Oct;12(5):445-50

Date

07/04/2008

Pubmed ID

18595756

Pubmed Central ID

PMC2604121

DOI

10.1016/j.jaapos.2008.03.005

Scopus ID

2-s2.0-53049110742 (requires institutional sign-in at Scopus site)   69 Citations

Abstract

PURPOSE: To report the outcome of nasolacrimal duct intubation as the primary treatment of congenital nasolacrimal duct obstruction (NLDO) in children younger than 4 years of age.

METHODS: A total of 182 eyes of 139 children receiving intubation with planned tube retention for 2 to 5 months were enrolled in a prospective, nonrandomized observational multicenter study (19 sites). Children were ages 6 months to <45 months at the time of surgery, with no previous nasolacrimal surgical procedures and had at least one of the following clinical signs of NLDO: epiphora, mucous discharge, and/or increased tear lake.

RESULTS: Treatment success was defined as absence of epiphora, mucous discharge, and increased tear lake at the outcome visit, 1 month after tube removal. The surgical outcome was assessed in 150 eyes (82% of cohort). The proportion of eyes treated successfully was 91% (95% CI: 86%-95%). The outcome dye disappearance test was normal in 125 (86%) eyes, indeterminate in 13 (9%), and abnormal in 7 (5%) of the 145 eyes tested. Monocanalicular tubes were used in 74% of cases. The tube was removed before the planned minimum retention time of 2 months in 61 eyes (41%). For 23 eyes, the early removal was attributed to inadvertent displacement by the patient.

CONCLUSIONS: In children 6 months to <45 months of age, nasolacrimal duct intubation in a nonrandomized and noncomparative trial was a successful primary treatment of NLDO in about 90% of cases not lost to follow-up.

Author List

Pediatric Eye Disease Investigator Group, Repka MX, Melia BM, Beck RW, Atkinson CS, Chandler DL, Holmes JM, Khammar A, Morrison D, Quinn GE, Silbert DI, Ticho BH, Wallace DK, Weakley DR Jr

Author

Alexander Joseph Khammar MD Associate Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child, Preschool
Cohort Studies
Device Removal
Female
Fluorescein
Fluorescent Dyes
Humans
Infant
Intubation
Lacrimal Apparatus Diseases
Lacrimal Duct Obstruction
Male
Nasolacrimal Duct
Prospective Studies
Quality of Life
Surveys and Questionnaires
Tears
Treatment Outcome