Office- or Facility-Based Probing for Congenital Nasolacrimal Duct Obstruction

PurposeTo review the published literature assessing efficacy and safety of in-office probing compared with facility-based to treat congenital nasolacrimal duct obstruction (NLDO).MethodsLiterature searches were conducted in March 2020 PubMed database no date restrictions limited studies English Cochrane Library restrictions. The combined yielded 281 citations. Of these, 21 articles deemed appropriate for inclusion this assessment assigned a level evidence rating by panel methodologist. Four rated I, 2 II, 15 III.ResultsTreatments consisted observation, probing, or probing. Success rates complications recurrences recorded from 1 week 6 months after surgery. Complete resolution symptoms surgery ranged 66% 95.6% office-based procedures versus 50% 97.7% procedures. Level I indicated that cases spontaneously resolved observation infants between 10 age. lower bilateral than unilateral NLDO (67% vs. 82%), whereas success high both (83%) (82%) patients who underwent observation. Cost data did not indicate definitive cost savings either treatment method ($562 $701 facility-based, depending on models predicting spontaneous at different ages). No serious adverse events anesthesia reported method.ConclusionsEvidence supports NLDO. However, treating facility setting may be better. Because significant percentage children achieved before 12 age, deferring until 18 age is reasonable option. Additional research address symptom burden families impact emotional trauma nonsedated office probings explore further each method. To (NLDO). Literature III. Treatments Evidence