Treatment of congenital nasolacrimal duct obstruction with high-pressure irrigation under topical anesthesia.
OBJECTIVE
To evaluate the effectiveness, safety, and success rate of high-pressure irrigation (HPI) applied under topical anesthesia in outpatient treatment of congenital nasolacrimal duct obstruction.


METHODS
HPI was applied under topical anesthesia to 39 eyes of 32 consecutive patients with congenital nasolacrimal duct obstruction. If obstructive symptoms persisted after the first attempt, treatment was repeated within 1 month. Patients were divided in two age groups: 7 to 12 months and 12 to 18 months. The two groups were compared in terms of the number of attempts needed to resolve the obstruction.


RESULTS
Thirty-nine eyes that had failed conservative treatment underwent high-pressure irrigation. The overall success rate was 31 of 39 (79.48%) at the first attempt; complete success (8/8, 100%) was achieved at the second attempt. The success rate in the younger group was 18 of 22 (81.8%) at the first attempt and 4 of 4 (100%) at the second attempt. The success rate in the older group was 13 of 17 (76.5%) at the first attempt and 4 of 4 (100%) at the second attempt. There was no statistically significant difference between the two groups regarding the number of attempts needed to relieve the symptoms (p > 0.05). There was no statistically significant difference in massage times and age between cases resolved at the first and second attempts (p > 0.05).


CONCLUSIONS
HPI can be attempted as an alternative second-step treatment or as a transition procedure between conservative and invasive methods. HPI has the advantage of being less invasive than other secondary methods, and its application under topical anesthesia seems to be safe and effective.
Alagöz
Gürsoy
G
Department of Ophthalmology, Abant Izzet Baysal Medical Faculty, Gölköy, Bolu, Turkey. gursoyalagoz@hotmail.com
Serin
Didem
D
Celebi
Serdal
S
Kükner
Sahap
S
Elçioğlu
Mustafa
M
Güngel
Hülya
H
D000772:Anesthesia, Local; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007767:Lacrimal Duct Obstruction / Q000151:congenital* / Q000628:therapy*; D010045:Outpatients; D011312:Pressure; D007507:Therapeutic Irrigation / Q000379:methods*; D016896:Treatment Outcome