Balloon dacryocystoplasty and monocanalicular intubation with Monoka tubes in the treatment of congenital nasolacrimal duct obstruction

To report our experience with combined use of balloon dacryocystoplasty and monocanalicular intubation with Monoka tubes for treating congenital nasolacrimal duct obstruction. Retrospective consecutive interventional case series. This retrospective study consisted of 25 consecutive pediatric patients with congenital nasolacrimal duct obstruction who underwent balloon dacryocystoplasty and monocanalicular intubation with Monoka tubes between November 2003 and November 2006. Outcome evaluations included an ophthalmologic examination and a dye appearance test postoperatively. Age, history of a prior probing and complications related to the main outcome were also analyzed. Thirty-three eyes of 25 patients aged 8 months to 9 years (3.5 +/- 2.4 years old) were included. Of the obstructed ducts treated, 97% (32/33) showed complete resolution of epiphoria. When analyzed by age groups, patients more than 1 year of age had higher success rate (30 successes in 30 patients) than patients less than 1 year of age (two successes in three patients). Statistical analysis revealed no statistically significant difference in success rate between both age groups (p = 0.09). The mean duration of intubation was 5.7 +/- 2.2 months. No significant complication was noted, except that early tube dislodgements occurred in six out of 31 Monoka intubations (19%). The combined use of balloon dacryocystoplasty and monocanalicular intubation with Monoka tubes is an effective procedure for children with congenital nasolacrimal duct obstruction after failure of conservative treatment or probing.