Balloon dacryocystoplasty as the primary treatment in older children with congenital nasolacrimal duct obstruction.
OBJECTIVE
To report the outcomes of balloon dacryocystoplasty of the lacrimal duct with inferior turbinate infracture as a primary treatment of congenital nasolacrimal duct obstruction in children 18 months of age or older.


METHODS
This study was a 3-year, prospective, interventional case series, consisting of 83 consecutive patients with congenital nasolacrimal duct obstruction who underwent balloon dacryocystoplasty as their primary treatment modality. Outcome evaluations included an ophthalmologic examination and a dye disappearance test at 3 weeks and 6 months postoperatively. We analyzed the different age groups and the types of obstruction noted at surgery to determine their respective influences on patient outcomes. We used the chi-square test for statistical analysis.


RESULTS
Seventy-two patients aged 18 to 112 months (mean 30 months) were included. Overall, 57 patients (79%) had good outcomes from balloon dacryocystoplasty. When analyzed by type of obstruction, 34/42 patients (81%) with simple membranous obstruction at the valve of Hasner had good outcomes and 23/30 patients (77%) with stenosis that extended along the length of the distal NLD had good outcomes (P = 0.60, power 0.62). Age did not significantly affect outcomes (P = 0.66, power 0.72).


CONCLUSIONS
Balloon dacryocystoplasty is probably more effective than simple probing in older children with stenosis extending along the distal nasolacrimal duct obstruction.
Chen
Po-Liang
PL
Department of Ophthalmology, Tri-Service General Hospital, Taipei, Taiwan, R.O.C. ddff36@yahoo.com.tw
Hsiao
Chih-Hsien
CH
D002404:Catheterization / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003608:Dacryocystorhinostomy / Q000379:methods*; D006801:Humans; D007223:Infant; D007767:Lacrimal Duct Obstruction / Q000151:congenital* / Q000628:therapy*; D009301:Nasolacrimal Duct; D011446:Prospective Studies; D016896:Treatment Outcome