Outcome of probing for congenital naolacrimal duct obtruction in older children

PURPOE: To evaluate the role of probing in congenital naolacrimal duct obtruction in children age 2 year and older and to etablih factor predictive of the outcome. METHOD: The tudy wa a ingle-center, propective, interventional cae erie. ixty patient with congenital naolacrimal duct obtruction aged 24 month or older (range, 24 to 186 month; median, 33 month) preenting conecutively to the author’ intitutional referral practice were tudied. Probing of the naolacrimal ytem under general anetheia wa the urgical intervention. ucce of probing wa the main outcome meaure. ucce wa predefined a complete reolution of ymptom and ign (tearing, cruting, dicharge, regurgitation on preure over the lacrimal ac) of congenital naolacrimal duct obtruction within 3 week of the procedure and continued remiion at 6 month. Two attempt at probing were neceary before the procedure wa declared a failure. REULT: One attempt at probing reulted in reolution in 73.3% (44 of 60) patient. ixteen patient needed a repeat procedure. The overall ucce rate wa 80% (48 of 60). Two pecific type of obtruction of the naolacrimal duct were recognized on probing: membranou and firm. Factor predictive of failure of probing were age older than 36 month (P < .0001); bilateral affection (P = .012); failed conervative therapy (P = .015); failed earlier probing (P < .0001); dilated lacrimal ac (P < .0001); and firm obtruction (P < .0001). CONCLUION: Reult indicate that probing i a viable primary urgical option for congenital naolacrimal duct obtruction in children who preent between 2 and 3 year of age, and identify factor predictive of poor prognoi.