Document Detail


Evaluation of treatment modalities and prognostic factors in children with congenital nasolacrimal duct obstruction.
MedLine Citation:
PMID:  22370666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the success rates of probing and silicone intubation and risk factors for failure of these procedures.
METHODS: This retrospective cohort study included patients who were diagnosed with congenital nasolacrimal duct obstruction (NLDO) and underwent probing or intubation as the primary procedure. Demographic data, clinical features, intraoperative, and postoperative data were evaluated. The patients were divided into four subgroups based on age: 12-24 months, 25-36 months, 37-48 months, and >48 months. The procedure was considered successful when all preoperative signs disappeared with normal dye disappearance test and a positive Jones primary dye test. Statistical analysis was performed to determine the risk factors for failure, and P < 0.05 was statistically significant.
RESULTS: The cohort comprised 350 subjects (162 males [46%]) who underwent a total of 454 nasolacrimal duct surgeries. The mean chronological age at time of surgery was 32.6 ± 22.1 months (range, 12-132 months). The overall success rate was 84.8%. Probing was performed 188 times, with a success rate of 80.3%; intubation was performed 266 times, with a success rate of 88%.
CONCLUSIONS: Intubation was more successful than probing in patients with bilateral congenital nasolacrimal duct obstruction, Down syndrome, history of acute dacryocystitis, lack of preoperative massage, or intraoperative observation of either a "tight" obstruction or obstruction at sites other than at the level of Hasner's valve. Primary nasolacrimal duct intubation should be considered in these higher risk patients.
Authors:
Yasser H Al-Faky; Nora Al-Sobaie; Ahmad Mousa; Hessa Al-Odan; Reem Al-Huthail; Essam Osman; Abdul Rahman Al-Mosallam
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus     Volume:  16     ISSN:  1528-3933     ISO Abbreviation:  J AAPOS     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-28     Completed Date:  2012-05-14     Revised Date:  2012-12-17    
Medline Journal Info:
Nlm Unique ID:  9710011     Medline TA:  J AAPOS     Country:  United States    
Other Details:
Languages:  eng     Pagination:  53-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. alfaky@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Dacryocystitis / complications
Down Syndrome / complications
Female
Humans
Infant
Intubation / methods
Lacrimal Duct Obstruction / congenital,  surgery*
Male
Nasolacrimal Duct / surgery*
Preoperative Care
Retrospective Studies
Risk Factors
Treatment Outcome
Waiting Lists
Comments/Corrections
Comment In:
J AAPOS. 2012 Oct;16(5):492; author reply 492   [PMID:  23084394 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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