Congenital nasolacrimal duct obstruction conservative treatment in infants using different techniques of nasolacrimal duct massage

Objective: To compare the effect of different techniques of nasolacrimal duct (NLD) massage on symptomatic improvement of congenital nasolacrimal duct obstruction (CNLDO). Methodology: A total of 108 clinically diagnosed CNLDO in 96 infants aged less than 6 months were included in the study, which lasted for one year. Patients were prospectively randomized into two groups using two different techniques of massaging of the NLD. During the follow up period, the nasolacrimal ducts were massaged by parents. Symptomatic improvement was evaluated every month for a period of 3 months and then we continued the study using the most effective technique of NLD massage up to one year. Results: After 3 months of conservative treatment from both groups; 58 patients and 66 ducts improved, Of them; 18 patients (37.5?) and 20 ducts (38.46?) were from the first group (simple technique of NLD massage), and 40 patients (83.3?) and 46 ducts (82.14?) from the second group (proper technique of NLD massage). After 6 months of conservative treatment, of the total 96 patients and 108 ducts; 70 (72.9?) patients and 82 (75.9?) ducts were improved while, after one year; 88 (91.66?) patients and 94 (87.03?) ducts were improved. Conclusion: By using the proper technique of NLD massage there was higher rate of spontaneous resolution of CNLD obstruction. The physician (ophthalmologist and/or pediatrician) has to spend much more time demonstrating the proper technique of NLD massage to the parents.