Management of congenital nasolacrimal duct obstruction--latin american study.

PURPOSE: To survey the management of congenital nasolacrimal duct obstruction, in particular, the timing of intervention and the use of massage, probing, nasolacrimal intubation, nasal endoscopy, and dacryocystorhinostomy.

METHODS: This was an exploratory study that used an electronic questionnaire, which was sent via Internet to the members of Ojoplast, a social network composed of ophthalmologists from several Latin American countries. The responses were analyzed using adherence and the chi-square test.

RESULTS: Seventy-two completed questionnaires were received. Approximately 64% of survey participants indicated that they use massage as the initial treatment for congenital nasolacrimal duct obstruction until 1 year of age and lacrimal probing (70.8%) for patients >1 year of age. Early probing used by 58.3% of the patients for a dilated lacrimal sac, and 66.7% reported that lacrimal system probing in conjunction with irrigation is effective. If the probing is not effective, 65.3% indicated that they repeat the procedure a second time. If the patient does not respond to massage or probing, 69.4% perform lacrimal system intubation. Sixty-two percent of the respondents indicated that they perform dacryocystorhinostomy for cases in which probing or intubation is not effective.

CONCLUSIONS: The members of Ojoplast adopt massage as the initial treatment for congenital nasolacrimal duct obstruction for patients <1 year of age. Probing is performed on patients >1 year of age, and early probing is used only for cases of dilated lacrimal sac. When massage and probing are not effective, intubation is performed, and if intubation is unsuccessful, dacryocystorhinostomy is performed, in which the external approach to dacryocystorhinostomy is used most often.