The effect of lacrimal sac massage, probing with irrigation or air insufflations in congenital nasolacrimal duct obstruction

Objective: The most common cause of lacrimation in children is congenital nasolacrimal duct obstruction. Although there is a belief that the most of them resolve spontaneously, there is no agreement in the time and type of treatment. This study was done to determine the success rate of three approaches to treatment of congenital nasolacrimal duct obstruction in children aged 12-24 months. Material & Methods: From February 2006 to December 2006, 60 12-24 month-old children with congenital nasolacrimal duct obstruction were enrolled in this study. The parents that agreed to probing were divided accidentally into two groups of probing and irrigation, and probing and air insufflation. The parents that agreed to wait for a month went to conservative management with office massage of the nasolacrimal duct and treatment with antibiotics by ophthalmologist. Findings: Of 60 children included in this study 27(45%) were females and 33(55%) males. The mean age of children in the group of probing with irrigation was 18.09 months, probing and air insufflation 19.44 months, and in group of conservative management 19.41 months. The success rate was 91.30% in the group of probing and irrigation, 96% in the group of probing and air insufflation, and 100% in the group for conservative treatment. Conclusion: Congenital nasolacrimal duct obstruction in almost all of children resolved spontaneously or by simple surgical intervention (probing). The persistent cases may have structural abnormality in nasolacrimal duct or nasal anatomy. Our study showed that conservative and surgical approach in children aged 12-24 months have a favorable outcome, therefore the age can not be a relevant factor in selection of the type of treatment in congenital nasolacrimal duct obstruction.