Efficacy of probing for children with congenital nasolacrimal duct obstruction: a retrospective study using fluorescein dye disappearance test and lacrimal sac echography.
OBJECTIVE
To evaluate B-scan echography for the assessment of lacrimal sac (LS) in pediatric epiphora secondary to congenital nasolacrimal duct obstruction (CNLDO), and to verify its predictive role in functional efficacy of nasolacrimal duct probing.


METHODS
Thirty-nine eyes of 23 consecutive children, treated with a single probing for persistent CNLDO-related epiphora, were retrospectively studied. These cases were investigated both collectively and considering two sub-groups: group A (ten patients [20 eyes] <or=13 months) and group B (13 patients [19 eyes] >13 months. Fluorescein dye disappearance test at 10 minutes (FDDT-10) and ultrasound examination of LS were performed before and after probing. An echographic LS scoring system (grade 0 = no LS enlargement; grade 1 = slight longitudinal LS enlargement; grade 2 = longitudinal and slight transverse LS enlargement; grade 3 = marked longitudinal and transverse LS enlargement) was introduced as a predictor of probing efficacy, estimating FDDT-10 modification between pre- and post-operative checks.


RESULTS
Echographic LS evaluation was easily practicable without sedation. In the total cluster and in both age sub-groups, post-probing FDDT-10 decreased with respect to pre-probing value (p < 0.001). Post-probing LS score improved with respect to pre-probing check within the total cluster and group A (p < 0.05). Strong correlation between pre-probing LS alteration and functional probing failure was present in each studied cluster (all p values <0.0001). Within group B, a greater gain of post-probing FDDT-10 was more frequent in patients with a better pre-probing LS score, as well as in younger children (both p values <0.0001).


CONCLUSIONS
In children with CNLDO-related epiphora, B-scan echography of the LS can represent a reliable and useful examination for a better understanding of the functional prognosis after probing treatment.
Steindler
Piero
P
Unit of Ophthalmology, ULSS 15 Alta Padovana, Camposampiero Hospital, Camposampiero, Italy.
Mantovani
Enrico
E
Incorvaia
Carlo
C
Parmeggiani
Francesco
F
D002675:Child, Preschool; D003608:Dacryocystorhinostomy; D005260:Female; D019793:Fluorescein; D005456:Fluorescent Dyes; D006801:Humans; D007223:Infant; D007767:Lacrimal Duct Obstruction / Q000151:congenital / Q000000981:diagnostic imaging; D008297:Male; D009301:Nasolacrimal Duct / Q000000981:diagnostic imaging* / Q000601:surgery*; D009339:Needles; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D007507:Therapeutic Irrigation; D016896:Treatment Outcome; D014463:Ultrasonography
D005456:Fluorescent Dyes; D019793:Fluorescein