title: Late and very late initial probing for congenital nasolacrimal duct obstruction: what is the cause of failure?
abstract: OBJECTIVE
  To find the cure rate of late (second year of age) and very late (3-5 years of age) initial probing for congenital nasolacrimal duct obstruction (CNLDO) and to identify the factors contributing to the failure rate of the probing in older children.
  
  
  METHODS
  In a prospective interventional case series study, 169 eyes of 125 consecutive patients (1-5 years old) with CNLDO underwent probing under general anaesthesia. Cure was defined as absence of tearing and discharge in the affected eye.
  
  
  RESULTS
  138 eyes of 101 patients aged 13-60 months (mean 23.4 (SD 10.2)) were included. Of 15 eyes (10.8%) with complex CNLDO, 80% presented after 24 months of age (p<0.0001). The cure rate was 89% in patients 13-24 months of age and 72% after the age of 24 months (p = 0.01). It was 90.2% in the membranous and 33.3% in the complex CNLDO in both late and very late probing (p<0.0001). There was a high correlation (r = 0.97) and no significant difference between the cure rate at 1 week and final follow up.
  
  
  CONCLUSIONS
  Accumulation of the complex CNLDO is the main risk factor for failure of probing in the older children. The outcome of the nasolacrimal duct probing at 1 week follow up is highly indicative of the final outcome.
authors.affiliation: Ocular Adnexal Unit, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. bahmanik@yahoo.com
authors.forename: M B
authors.initials: MB
authors.lastname: Kashkouli
authors.forename: B
authors.initials: B
authors.lastname: Beigi
authors.forename: M M
authors.initials: MM
authors.lastname: Parvaresh
authors.forename: A
authors.initials: A
authors.lastname: Kassaee
authors.forename: Z
authors.initials: Z
authors.lastname: Tabatabaee
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D003607:Dacryocystitis / Q000209:etiology / Q000601:surgery; D003608:Dacryocystorhinostomy; D005260:Female; D006801:Humans; D007223:Infant; D007767:Lacrimal Duct Obstruction / Q000151:congenital*; D008297:Male; D009301:Nasolacrimal Duct; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D012044:Regression Analysis; D017211:Treatment Failure