title: Lacrimal drainage obstruction and dacryocystorhinostomy in children.
abstract: OBJECTIVE
  To determine the outcome of dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction (NLDO) in children.
  
  
  METHODS
  A review of medical records of 104 cases (82 patients) of paediatric DCR who underwent DCR at the Sydney Eye Hospital from 1995 to 2004. The main outcome measures included post-operative symptomatic relief of presenting symptoms, complications, subjective visibility of any scar, and general satisfaction. Statistical methods included chi(2) tests, and Student's t-tests for the comparison of variables among groups.
  
  
  RESULTS
  Ninety-four external, 10 endoscopic primary procedures, and five revision procedures were included. Fifty-six of the cases were primary NLDO, and 48 were secondary NLDO. The mean follow-up was 1.44 years. Average age at surgery was 6.6+/-4.2 years (mean+/-SD). Ninety-one eyes needed DCR for the involvement of the lower lacrimal outflow system, and 13 eyes were NLDO associated with congenital punctual/canalicular dysgenesis.Most of the complications of external DCR were related to Jones tube placement. Five cases (4.8%) needed DCR revision. There was a significantly higher incidence of revision surgery in the non-stented group (P<0.01), and the Jones tube group (P<0.001) as compared with the silicone intubation stent group.
  
  
  CONCLUSIONS
  External DCRs have acceptable long-term clinical and cosmetic results, and low post-operative complication rate. Cases with punctal stenosis or those requiring Jones tube insertion are associated with a higher complication rate. Silicone intubation is associated with a lower need for operative revision.
authors.affiliation: Oculoplastic unit, Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital, Sydney, New South Wales, Australia. nemeta@yahoo.com
authors.forename: A Y
authors.initials: AY
authors.lastname: Nemet
authors.forename: A
authors.initials: A
authors.lastname: Fung
authors.forename: P A
authors.initials: PA
authors.lastname: Martin
authors.forename: R
authors.initials: R
authors.lastname: Benger
authors.forename: G
authors.initials: G
authors.lastname: Kourt
authors.forename: J J
authors.initials: JJ
authors.lastname: Danks
authors.forename: J C
authors.initials: JC
authors.lastname: Tong
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000473:pathology; D003608:Dacryocystorhinostomy / Q000009:adverse effects / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007223:Infant; D007767:Lacrimal Duct Obstruction / Q000209:etiology; D008297:Male; D009301:Nasolacrimal Duct / Q000601:surgery; D017060:Patient Satisfaction; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome