Late Probing for Congenital Nasolacrimal Duct Obstruction

OBJECTIVE To determine the outcome of late Nasolacrimal Duct (NLD) probing in children 2 years and above and to identify the cause of failure in these children. STUDY DESIGN Quasi- experimental. PLACE AND DURATION OF STUDY Shri Ganapati Netralaya, Jalna, India, from January 1999 to June 2003. PATIENTS AND METHODS Clinical diagnosis of Congenital Nasolacrimal Duct Obstruction (CNLDO) was defined in a child who presented with history of tearing and/or eye discharge. Probing was performed under general anesthesia. Intraoperative patency of probing was determined when fluorescein stained saline was recovered from throat after syringing. The type of obstruction was noted in each case as simple obstruction where the probe could bypass the obstruction and post-probing syringing was patent in these cases, and complex where the probe was snugly fit and/or could not pass the obstruction and syringing was not patent in these patients. Success was the main outcome measure and was defined as complete resolution of tearing and discharges in the affected eye. RESULTS Forty-nine eyes of 42 children were included in the study. The age range was from 2-7 years (average age 3.7 years). Probing was successful in 39 eyes (79.60%). Success rate was 85% in children less than 5 years and 55.55% in those older than 5 years. Out of the failed 10 cases, 5 (50%) were above 5 years of age. All cases with failed probing had complex type obstruction. CONCLUSION Probing is a viable option in older children. The success rate for probing depends upon the type of obstruction and children with complex obstruction are at high risk for failure of probing.