Prognostic value of metal-metal contact during nasolacrimal duct probing.

OBJECTIVE

To evaluate the prognostic value of metal-metal contact during nasolacrimal duct (NLD) probing in patients with simple membranous versus complex congenital NLD obstructions (CNLDO).

DESIGN

Retrospective case series.

PARTICIPANTS

Infants diagnosed with CNLDO.

METHODS

Seventy-nine eyes of 70 infants with CNLDO who underwent probing were recruited. Metal-metal contact was sought during probing in every patient. CNLDO was classified into simple membranous versus complex type of obstruction. Complete resolution of epiphora, increased tear meniscus, and mucous discharge were defined as successful outcome.

RESULTS

The mean age of patients at the time of probing was 21.0 ± 8.3 (range 1-42) months. Postoperative evaluations were performed in all patients between the first and second postoperative months. Overall success rate of probing was 84.9%. A higher success rate was obtained in membranous (89.7%) versus complex (54.5%) obstructions (p = 0.01). A metal-metal contact could be established in 62 (78.5%) eyes. Treatment success was achieved in 93.5% of cases in which metal-metal contact was detected versus 52.9% of cases without metal-metal contact (p < 0.001). Among cases with metal-metal contact, a trend toward successful outcomes was observed with membranous as compared with complex obstructions (96.4% vs 71.4%, p = 0.059). Logistic regression analysis revealed the presence of metal-metal touch (odds ratio [OR] 13.3, p = 0.001) and membranous type obstruction (OR 7.7, p = 0.019) as significant factors for a successful outcome.

CONCLUSIONS

Establishment of metal-metal contact is an important prognostic sign for surgical success in both the membranous and the complex type of CNLDO.