title: The natural process of congenital nasolacrimal duct obstruction and effect of lacrimal sac massage.
abstract: This study aimed to examine the rate of symptomatic improvement of congenital nasolacrimal duct obstruction (CNLDO) in infants treated with conservative management within the first year of age. Other purpose of the study is to emphasize the relationship between spontaneous resolution time and effective lacrimal sac massage. Thirty-one infants were diagnosed to have CNLDO by an ophthalmologist prior to 3 months of age. In this study, 36 eyes of 31 patients were included with CNLDO. The patients were divided into two groups. Group 1 (28 eyes of 24 patients) was consisted of the patients who were applied effective lacrimal sac massage regularly during the follow-up period, and patients whose parents did not apply a regular lacrimal passage regularly were accepted as group 2 (8 eyes of 7 patients). Thirty-three eyes of 31 patients (18 rights and 15 left) successfully resolved with only conservative management (91.6 %). In these thirty-three eyes, one eye (3 %) resolved between 0 and 3 months, fourteen eyes (42.5 %) resolved between 4 and 6 months, eleven eyes (33.3 %) resolved between 7 and 9 months, and seven eyes (21.2 %) resolved between 10 and 12 months. CNLDO was resolved in 27 (96.2 %) of 28 eyes in group 1, and in group 2, six eyes (77.7 %) had resolvement. This difference was statistically significant (p = 0.001). The mean age of resolution was 6.8 ± 1.88 months in group 1, 10.3 ± 1.5 months in group 2 (p < 0.001). In light of our study, we believe that conservative management of CNLDO is highly successful. Our study provided a possible objective explanation for the efficacy of lacrimal sac massage. Emphasizing the importance of the massage to parents and describing in detail can reduce the risk of unnecessary surgical interventions.
authors.affiliation: Department of Ophthalmology, Bozyaka Training and Research Hospital, Çatalkaya Mah, Gunaydın sok, Zümrütevler Sitesi, No: 1/8 Narlıdere, Izmir, Turkey. omer.karti@deu.edu.tr.
authors.forename: Omer
authors.initials: O
authors.lastname: Karti
authors.affiliation: Department of Ophthalmology, Sifa University, Izmir, Turkey.
authors.forename: Eyyup
authors.initials: E
authors.lastname: Karahan
authors.affiliation: Department of Ophthalmology, Bozyaka Training and Research Hospital, Çatalkaya Mah, Gunaydın sok, Zümrütevler Sitesi, No: 1/8 Narlıdere, Izmir, Turkey.
authors.forename: Durgul
authors.initials: D
authors.lastname: Acan
authors.affiliation: Department of Ophthalmology, Bozyaka Training and Research Hospital, Çatalkaya Mah, Gunaydın sok, Zümrütevler Sitesi, No: 1/8 Narlıdere, Izmir, Turkey.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Kusbeci
mesh_terms: D016022:Case-Control Studies; D000072700:Conservative Treatment / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007767:Lacrimal Duct Obstruction / Q000151:congenital* / Q000628:therapy*; D008297:Male; D008405:Massage; D009301:Nasolacrimal Duct; D009668:Nose Diseases / Q000151:congenital / Q000628:therapy*; D012075:Remission, Spontaneous; D012189:Retrospective Studies
keywords: Congenital nasolacrimal duct obstruction; Epiphora; Lacrimal sac massage