title: Nasolacrimal Duct Probing under Topical Anesthesia for Congenital Nasolacrimal Duct Obstruction in Taiwan.
abstract: BACKGROUND
  To report the success rates of office probing for congenital nasolacrimal duct obstruction (NLDO) among children of different age groups in Taiwan.
  
  
  METHODS
  In this single-center, retrospective study, 564 eyes of 477 patients under the age of 5 years diagnosed with congenital NLDO were treated in a stepwise manner between 2001 and 2013. For infants aged < 6 months, treatment with massage and observation was suggested, followed by deferred probing under topical anesthesia if symptoms persisted. However, in cases of severe infection, immediate probing was suggested. In children aged > 6 months, office probing was usually highly recommended. Those with probing failures received either a second probing or silicone intubation. Treatment success was defined as anatomic patency by immediate irrigation after probing and absence of epiphora or mucous discharge at the follow-up visit.
  
  
  RESULTS
  Primary probing was successful in 457 of 564 eyes (success rate: 81%). The success rate of primary probing was negatively correlated with increasing age: 90.1% (163/181), 79.6% (164/206), 76.8% (73/95), 73.5% (36/49), 75% (18/24), and 33% (3/9) for the age groups of 0 to <6 months, 6 to <12 months, 12 to <18 months, 18 to <24 months, 24 to <36 months, and 36-60 months, respectively (p < 0.001, Fisher's exact test). The second probing was successful in 52 of 81 eyes. In total, probing was successful in 509 of 564 eyes (success rate: 90.2%).
  
  
  CONCLUSIONS
  Office probing is safe and effective for treating congenital NLDO. The success rate of primary probing decreases significantly with age.
authors.affiliation: Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Chih-Heng
authors.initials: CH
authors.lastname: Hung
authors.affiliation: Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan; Medical College, National Taiwan University, Taipei, Taiwan; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: linshunling@yahoo.com.
authors.forename: Shun-Ling
authors.initials: SL
authors.lastname: Lin
authors.affiliation: Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Wei-Lun
authors.initials: WL
authors.lastname: Chen
mesh_terms: D000367:Age Factors; D000556:Ambulatory Surgical Procedures; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002675:Child, Preschool; D003608:Dacryocystorhinostomy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007767:Lacrimal Duct Obstruction / Q000151:congenital*; D008297:Male; D009301:Nasolacrimal Duct / Q000601:surgery*; D011430:Propoxycaine / Q000627:therapeutic use*; D012189:Retrospective Studies; D013624:Taiwan
chemical_list: D000779:Anesthetics, Local; C005717:proxymetacaine; D011430:Propoxycaine
keywords: congenital nasolacrimal duct obstruction; office probing