Primary treatment of nasolacrimal duct obstruction with nasolacrimal duct intubation in children younger than 4 years of age.
OBJECTIVE
To report the outcome of nasolacrimal duct intubation as the primary treatment of congenital nasolacrimal duct obstruction (NLDO) in children younger than 4 years of age.


METHODS
A total of 182 eyes of 139 children receiving intubation with planned tube retention for 2 to 5 months were enrolled in a prospective, nonrandomized observational multicenter study (19 sites). Children were ages 6 months to <45 months at the time of surgery, with no previous nasolacrimal surgical procedures and had at least one of the following clinical signs of NLDO: epiphora, mucous discharge, and/or increased tear lake.


RESULTS
Treatment success was defined as absence of epiphora, mucous discharge, and increased tear lake at the outcome visit, 1 month after tube removal. The surgical outcome was assessed in 150 eyes (82% of cohort). The proportion of eyes treated successfully was 91% (95% CI: 86%-95%). The outcome dye disappearance test was normal in 125 (86%) eyes, indeterminate in 13 (9%), and abnormal in 7 (5%) of the 145 eyes tested. Monocanalicular tubes were used in 74% of cases. The tube was removed before the planned minimum retention time of 2 months in 61 eyes (41%). For 23 eyes, the early removal was attributed to inadvertent displacement by the patient.


CONCLUSIONS
In children 6 months to <45 months of age, nasolacrimal duct intubation in a nonrandomized and noncomparative trial was a successful primary treatment of NLDO in about 90% of cases not lost to follow-up.
Repka
Michael X
MX
Melia
B Michele
BM
Beck
Roy W
RW
Atkinson
C Scott
CS
Chandler
Danielle L
DL
Holmes
Jonathan M
JM
Khammar
Alexander
A
Morrison
David
D
Quinn
Graham E
GE
Silbert
David I
DI
Ticho
Benjamin H
BH
Wallace
David K
DK
Weakley
David R
DR
D002675:Child, Preschool; D015331:Cohort Studies; D020878:Device Removal; D005260:Female; D019793:Fluorescein / Q000493:pharmacokinetics; D005456:Fluorescent Dyes / Q000493:pharmacokinetics; D006801:Humans; D007223:Infant; D007440:Intubation / Q000009:adverse effects; D007766:Lacrimal Apparatus Diseases / Q000209:etiology; D007767:Lacrimal Duct Obstruction / Q000150:complications / Q000151:congenital / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D009301:Nasolacrimal Duct; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013666:Tears / Q000378:metabolism; D016896:Treatment Outcome
D005456:Fluorescent Dyes; D019793:Fluorescein