title: Evaluation of treatment modalities and prognostic factors in children with congenital nasolacrimal duct obstruction.
abstract: OBJECTIVE
  To evaluate the success rates of probing and silicone intubation and risk factors for failure of these procedures.
  
  
  METHODS
  This retrospective cohort study included patients who were diagnosed with congenital nasolacrimal duct obstruction (NLDO) and underwent probing or intubation as the primary procedure. Demographic data, clinical features, intraoperative, and postoperative data were evaluated. The patients were divided into four subgroups based on age: 12-24 months, 25-36 months, 37-48 months, and >48 months. The procedure was considered successful when all preoperative signs disappeared with normal dye disappearance test and a positive Jones primary dye test. Statistical analysis was performed to determine the risk factors for failure, and P < 0.05 was statistically significant.
  
  
  RESULTS
  The cohort comprised 350 subjects (162 males [46%]) who underwent a total of 454 nasolacrimal duct surgeries. The mean chronological age at time of surgery was 32.6 ± 22.1 months (range, 12-132 months). The overall success rate was 84.8%. Probing was performed 188 times, with a success rate of 80.3%; intubation was performed 266 times, with a success rate of 88%.
  
  
  CONCLUSIONS
  Intubation was more successful than probing in patients with bilateral congenital nasolacrimal duct obstruction, Down syndrome, history of acute dacryocystitis, lack of preoperative massage, or intraoperative observation of either a "tight" obstruction or obstruction at sites other than at the level of Hasner's valve. Primary nasolacrimal duct intubation should be considered in these higher risk patients.
authors.affiliation: Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. alfaky@gmail.com
authors.forename: Yasser H
authors.initials: YH
authors.lastname: Al-Faky
authors.forename: Nora
authors.initials: N
authors.lastname: Al-Sobaie
authors.forename: Ahmad
authors.initials: A
authors.lastname: Mousa
authors.forename: Hessa
authors.initials: H
authors.lastname: Al-Odan
authors.forename: Reem
authors.initials: R
authors.lastname: Al-Huthail
authors.forename: Essam
authors.initials: E
authors.lastname: Osman
authors.forename: Abdul Rahman
authors.initials: AR
authors.lastname: Al-Mosallam
mesh_terms: D002648:Child; D002675:Child, Preschool; D003607:Dacryocystitis / Q000150:complications; D003608:Dacryocystorhinostomy; D004314:Down Syndrome / Q000150:complications; D005260:Female; D006801:Humans; D007223:Infant; D007440:Intubation / Q000379:methods; D007767:Lacrimal Duct Obstruction / Q000151:congenital; D008297:Male; D009301:Nasolacrimal Duct / Q000601:surgery*; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014850:Waiting Lists