Probing without Irrigation in Children with Congenital Nasolacrimal Duct Obstruction

Purpose: The purpose of this study was to evaluate the results of probing, without fluorescein irrigation, as a primary treatment for epiphora and/or mucous discharge, secondary to congenital nasolacrimal duct obstruction (CNLDO) Methods: The medical records of nine-two children (127 eyes) with CNLDO who underwent a single probing without the use of fluorescein irrigation between January 2006 and December 2011 were reviewed retrospectively. Inclusion criteria were no prior nasolacrimal surgical procedure, history of epiphora and/or discharge since birth or shortly after birth in one or both eyes and at least one of the following clinical signs: epiphora, muco-purulent discharge and increased tear meniscus height. Children were investigated in two sub-groups based on age at time of probing; group 1 (51 eyes/40 children) included children who underwent probing at age = 2 years and group 2 (76 eyes/52 children) included children who underwent probing at age > 2years. The primary outcome was the complete disappearance of symptoms and signs in the affected eye(s), assessed at 3 months after surgery. Results: The success rate for the overall sample was 83.5 % (106/127 eyes), in group 1 was 90.2% (46/51) and in group 2 was 78.9% (60/76). There was no significant difference in success rate between groups (p=0.094). Gender (p=0.292), affected eye (p=0.647) and bilateral cases (p=0.739) were not associated with successful elimination of symptoms. Conclusion: Probing without fluorescein irrigation for CNLDO beyond 1 year of age is highly successful and comparable to the published efficacy rates of the traditional probing with fluorescein irrigation.