title: Primary treatment of nasolacrimal duct obstruction with nasolacrimal duct intubation in children younger than 4 years of age.
abstract: 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.
authors.forename: Michael X
authors.initials: MX
authors.lastname: Repka
authors.forename: B Michele
authors.initials: BM
authors.lastname: Melia
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
authors.forename: C Scott
authors.initials: CS
authors.lastname: Atkinson
authors.forename: Danielle L
authors.initials: DL
authors.lastname: Chandler
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Holmes
authors.forename: Alexander
authors.initials: A
authors.lastname: Khammar
authors.forename: David
authors.initials: D
authors.lastname: Morrison
authors.forename: Graham E
authors.initials: GE
authors.lastname: Quinn
authors.forename: David I
authors.initials: DI
authors.lastname: Silbert
authors.forename: Benjamin H
authors.initials: BH
authors.lastname: Ticho
authors.forename: David K
authors.initials: DK
authors.lastname: Wallace
authors.forename: David R
authors.initials: DR
authors.lastname: Weakley
mesh_terms: 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
chemical_list: D005456:Fluorescent Dyes; D019793:Fluorescein