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Multicenter Study
. 2008 Oct;12(5):445-50.
doi: 10.1016/j.jaapos.2008.03.005. Epub 2008 Jul 2.

Primary treatment of nasolacrimal duct obstruction with nasolacrimal duct intubation in children younger than 4 years of age

Pediatric Eye Disease Investigator Group; Michael X Repka, B Michele Melia, Roy W Beck, C Scott Atkinson, Danielle L Chandler, Jonathan M Holmes, Alexander Khammar, David Morrison, Graham E Quinn, David I Silbert, Benjamin H Ticho, David K Wallace, David R Weakley Jr
Multicenter Study

Primary treatment of nasolacrimal duct obstruction with nasolacrimal duct intubation in children younger than 4 years of age

Pediatric Eye Disease Investigator Group et al. J AAPOS. 2008 Oct.

Abstract

Purpose: To report the outcome of nasolacrimal duct intubation as the primary treatment of congenital nasolacrimal duct obstruction (NLDO) in children younger than 4 years of age.

Methods: A total of 182 eyes of 139 children receiving intubation with planned tube retention for 2 to 5 months were enrolled in a prospective, nonrandomized observational multicenter study (19 sites). Children were ages 6 months to <45 months at the time of surgery, with no previous nasolacrimal surgical procedures and had at least one of the following clinical signs of NLDO: epiphora, mucous discharge, and/or increased tear lake.

Results: Treatment success was defined as absence of epiphora, mucous discharge, and increased tear lake at the outcome visit, 1 month after tube removal. The surgical outcome was assessed in 150 eyes (82% of cohort). The proportion of eyes treated successfully was 91% (95% CI: 86%-95%). The outcome dye disappearance test was normal in 125 (86%) eyes, indeterminate in 13 (9%), and abnormal in 7 (5%) of the 145 eyes tested. Monocanalicular tubes were used in 74% of cases. The tube was removed before the planned minimum retention time of 2 months in 61 eyes (41%). For 23 eyes, the early removal was attributed to inadvertent displacement by the patient.

Conclusions: In children 6 months to <45 months of age, nasolacrimal duct intubation in a nonrandomized and noncomparative trial was a successful primary treatment of NLDO in about 90% of cases not lost to follow-up.

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