Balloon catheter dilation and nasolacrimal duct intubation for treatment of nasolacrimal duct obstruction after failed probing.
OBJECTIVE
To compare the outcomes of balloon catheter dilation and nasolacrimal intubation as treatment for congenital nasolacrimal duct obstruction after failed probing in children younger than 4 years.


METHODS
We conducted a prospective, nonrandomized, multicenter study that enrolled 159 children aged 6 months to younger than 48 months who had a history of a single failed nasolacrimal duct probing and at least 1 of the following clinical signs of nasolacrimal duct obstruction: epiphora, mucous discharge, or increased tear lake. One hundred ninety-nine eyes underwent either balloon catheter nasolacrimal duct dilation or nasolacrimal duct intubation. Treatment success was defined as absence of epiphora, mucous discharge, or increased tear lake at the outcome visit 6 months after surgery.


RESULTS
Treatment success was reported in 65 of 84 eyes (77%; 95% confidence interval, 65%-85%) in the balloon catheter dilation group compared with 72 of 88 eyes (84% after adjustment for intereye correlation; 74%-91%) in the nasolacrimal intubation group (risk ratio for success for intubation vs balloon dilation, 1.08; 0.95-1.22).


CONCLUSIONS
Both balloon catheter dilation and nasolacrimal duct intubation alleviate the clinical signs of persistent nasolacrimal duct obstruction in a similar percentage of patients.
Repka
Michael X
MX
Jaeb Center for Health Research, Tampa, FL 33647, USA. pedig@jaeb.org
Chandler
Danielle L
DL
Holmes
Jonathan M
JM
Hoover
Darren L
DL
Morse
Christine L
CL
Schloff
Susan
S
Silbert
David I
DI
Tien
D Robbins
DR
D002404:Catheterization / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007440:Intubation / Q000379:methods*; D007767:Lacrimal Duct Obstruction / Q000151:congenital / Q000378:metabolism / Q000628:therapy*; D008297:Male; D009301:Nasolacrimal Duct; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism; D016896:Treatment Outcome