Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2025
Endoscopic and surgical evaluation of epiphora in children with Down syndrome.
СтатьяНазвание и аннотация: Перевод в очереди
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Nakamura Jutaro, Asano Mizuki, Ohno Tomoko, Goto Satoshi, Mizuki Nobuhisa, Matsumura Nozomi
Аннотация
PURPOSE: To examine the clinical characteristics and surgical outcomes of patients with Down syndrome (DS) presenting with primary epiphora.
METHODS: The medical records of children with DS referred to a tertiary academic children's hospital between 2013 and 2023 were reviewed, and 63 patients with primary epiphora were included in our analysis. Clinical characteristics, diagnostic findings, and surgical intervention outcomes were analyzed.
RESULTS: Forty-two patients (67%) had epiphora since birth, and 12 patients (19%) developed symptoms after the first year of life. Of the 40 patients who underwent lacrimal syringing, 28 (70%) showed passage, and 12 showed obstruction. Surgical intervention was performed in 18 patients. Either office-based probing under local anesthesia or endoluminal lacrimal duct recanalization (ELDR) with stent intubation under general anesthesia was performed. In the 18 patients who underwent surgery, surgical outcomes were as follows: complete resolution of symptoms in 7 patients, partial resolution in 10 patients, and failure in 1 patient. Dacryoendoscopy revealed dense white fibrous tissue obstructing the mucosal surface of the nasolacrimal duct in several cases, indicating chronic inflammatory changes.
CONCLUSIONS: Dacryoendoscopic findings revealed not only stenotic lacrimal passages due to developmental anomalies of the lacrimal drainage system but also fibrous obstruction secondary to chronic inflammation. Surgical intervention limited to probing or ELDR resulted in only partial symptom improvement in two-thirds of patients, without achieving complete resolution.
METHODS: The medical records of children with DS referred to a tertiary academic children's hospital between 2013 and 2023 were reviewed, and 63 patients with primary epiphora were included in our analysis. Clinical characteristics, diagnostic findings, and surgical intervention outcomes were analyzed.
RESULTS: Forty-two patients (67%) had epiphora since birth, and 12 patients (19%) developed symptoms after the first year of life. Of the 40 patients who underwent lacrimal syringing, 28 (70%) showed passage, and 12 showed obstruction. Surgical intervention was performed in 18 patients. Either office-based probing under local anesthesia or endoluminal lacrimal duct recanalization (ELDR) with stent intubation under general anesthesia was performed. In the 18 patients who underwent surgery, surgical outcomes were as follows: complete resolution of symptoms in 7 patients, partial resolution in 10 patients, and failure in 1 patient. Dacryoendoscopy revealed dense white fibrous tissue obstructing the mucosal surface of the nasolacrimal duct in several cases, indicating chronic inflammatory changes.
CONCLUSIONS: Dacryoendoscopic findings revealed not only stenotic lacrimal passages due to developmental anomalies of the lacrimal drainage system but also fibrous obstruction secondary to chronic inflammation. Surgical intervention limited to probing or ELDR resulted in only partial symptom improvement in two-thirds of patients, without achieving complete resolution.