Dacryostenosis in newborns: probing, or syringing, or both?

PURPOSE This prospective study was designed to establish whether it is more effective to treat symptomatic congenital nasolacrimal duct obstruction by probing, or high-pressure irrigation, or both. METHODS During the period February 1991 to January 1999, 228 infants (300 nasolacrimal ducts) were examined (132 males, 96 females, age range 12-13 months). These patients were divided into three groups of 100 ducts each. The first group was probed only; in the second group the nasolacrimal ducts were irrigated under high pressure using methylene blue-stained saline, and the third group was probed and irrigated in the same setting. The procedures were done under light general anesthesia. RESULTS Ninety-one ducts in the first group improved after probing. In the second group 64 ducts improved after irrigation. In the third group 96 ducts improved after both probing and irrigation. CONCLUSIONS To treat symptomatic congenital nasolacrimal duct obstruction, it is more effective to combine high-pressure irrigation and probing. This gives a better success rate, first in treatment and secondarily, permitting intraoperative verification of the patency of the excretory lacrimal system.