title: A prospective, randomised comparison of probing versus bicanalicular silastic intubation for congenital nasolacrimal duct obstruction.
abstract: OBJECTIVE
  To compare the success rates of probing versus bicanalicular silastic intubation as the primary treatment for congenital nasolacrimal duct obstruction (CNLDO) in children ≥1 year old.
  
  
  METHODS
  Prospective, randomised, comparison.
  
  
  METHODS
  Participants were randomised to undergo probing or bicanalicular silastic intubation. In bilateral cases, the right eye was used for analysis. The procedure was considered successful when all preoperative manifestations disappeared with normal dye disappearance test and a positive Jones primary dye test at least 6 months postoperatively. Secondary outcomes were risk factors for failure. Outcomes were compared between treatments with p<0.05 indicating statistical significance.
  
  
  RESULTS
  207 eyes of 181 children between 1 and 8 years old with CNLDO who had not undergone previous surgical treatment were included in the study. 88 eyes underwent probing with a 84.1% success rate and 93 eyes that underwent bicanalicular silastic intubation had a 89.2% success rate (p=0.429). For simple CNLDO, there was a 94.2% (65/69) success rate with probing and a 90.9% (60/66) success rate with bicanalicular silastic intubation (p=0.687). In complex CNLDO, there was a 47.4% (9/19; p=<0.001) success rate with probing and an 85.2% (23/27; p=0.419) success rate with silastic intubation (p=0.016). Age was not a risk factor for failure in either procedure.
  
  
  CONCLUSIONS
  Probing for simple CNLDO in young children is adequate. Bicanalicular silastic intubation seems to have a role in achieving successful outcomes in complex CNLDO.
authors.affiliation: Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Yasser H
authors.initials: YH
authors.lastname: Al-Faky
authors.affiliation: Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Ahmed
authors.identifier: http://orcid.org/0000-0002-9116-3547
authors.initials: A
authors.lastname: Mousa
authors.affiliation: Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Hatem
authors.initials: H
authors.lastname: Kalantan
authors.affiliation: Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al-Otaibi
authors.affiliation: Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Hessah
authors.initials: H
authors.lastname: Alodan
authors.affiliation: Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Adel H
authors.initials: AH
authors.lastname: Alsuhaibani
mesh_terms: D002648:Child; D002675:Child, Preschool; D003608:Dacryocystorhinostomy; D004129:Dimethylpolysiloxanes; D005260:Female; D019793:Fluorescein / Q000378:metabolism; D006801:Humans; D007223:Infant; D007440:Intubation / Q000295:instrumentation / Q000379:methods*; D007767:Lacrimal Duct Obstruction / Q000151:congenital / Q000175:diagnosis; D008297:Male; D009301:Nasolacrimal Duct / Q000002:abnormalities / Q000473:pathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism
chemical_list: D004129:Dimethylpolysiloxanes; C013830:baysilon; D019793:Fluorescein
keywords: Embryology and development; Lacrimal drainage