Success rate of late primary probing in congenital nasolacrimal duct obstruction.

PURPOSE: To investigate the clinical outcomes of late primary probing in congenital nasolacrimal duct (NLD) obstruction.

METHODS

A prospective interventional study was designed to recruit children older than 24 months who presented with clinical manifestations of NLD obstruction since February 2008 to Farabi Eye Hospital, Tehran, Iran. No prior surgical intervention for NLD obstruction was performed on these patients; they underwent probing of the nasolacrimal system and irrigation under general anesthesia by oculoplastic surgeons. The outcome of the procedure was assessed 2 to 3 months postoperatively. Data of the patients until February 2013 were considered for analysis.

RESULTS

The total number of patients during the 5-year study was 343. The total success rate considering all of the age groups was 75.8%. The success rate was 85% in those who were 2 to 3 years old, 63% in those who were 3 to 4 years old, and 50% in those who were 4 to 5 years old. In patients with chronic dacryocystitis with mucopurulent discharge, 83% had successful probing and irrigation. In patients with epiphora with no mucopurulent discharge, 59% had successful results with probing.

CONCLUSIONS

In the cases of congenital NLD obstruction, primary probing before 2 years of age has a high success rate; there is a high overall success rate (75.8%) in the 2- to 5-years age group, but when older than 5 years, further procedures such as intubation and dacryocystorhinostomy would be needed because of the high failure rate of probing.