title: Balloon catheter dilation for treatment of older children with nasolacrimal duct obstruction.
abstract: OBJECTIVE
  To describe the outcomes of balloon catheter dilation of the lacrimal duct as the first surgical treatment for older children (>or=18 months) with nasolacrimal duct (NLD) obstruction and to examine the effect of the type of obstruction on outcome.
  
  
  METHODS
  Retrospective noncomparative case series.
  
  
  METHODS
  Seventy-six children 18 months or older with NLD obstruction who had not undergone previous surgery.
  
  
  METHODS
  The patients underwent NLD probing, infracturing of the inferior turbinate, and balloon catheter dilation of the distal NLD. The type of obstruction was noted at surgery.
  
  
  METHODS
  Outcomes were considered excellent if the patient had complete resolution of epiphora and dacryocystitis and normal tear drainage on examination, good if the patient had only minimal residual symptoms or a minimally delayed dye disappearance test result, fair if the patient had moderate residual symptoms or delayed tear drainage, and poor if there was no improvement.
  
  
  RESULTS
  Seventy-six children were treated. Overall, results were excellent in 28 (37%) patients, good in 30 (39%), fair in 13 (17%), and poor in 5 (7%). Forty-eight (63%) of the patients had simple membranous obstruction at the Hasner valve. Results were good or excellent in 35 (73%) of these patients. Twenty-eight (37%) patients had stenosis that extended along the length of the distal NLD. Results were good or excellent in 23 (82%) of these patients.
  
  
  CONCLUSIONS
  Balloon catheter dilation is probably more effective than simple probing for older children with NLD obstruction because of stenosis that extends along the distal NLD. The procedure does not provide a significant advantage over simple NLD probing in patients with typical membranous obstruction at the Hasner valve.
authors.affiliation: Department of Ophthamology, St Louis Children's Hospital at Washington University School of Medicine, One Children's Place, Room 2s89, St Louis, MO 63110, USA. lueder@vision.wustl.edu
authors.forename: Gregg T
authors.initials: GT
authors.lastname: Lueder
mesh_terms: D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007767:Lacrimal Duct Obstruction / Q000628:therapy*; D009301:Nasolacrimal Duct; D012189:Retrospective Studies; D016896:Treatment Outcome