Perioperative use of intravenous dexamethasone in the management of congenital nasolacrimal duct obstruction with balloon dacryoplasty.

PURPOSE

To evaluate the effect of perioperative dexamethasone, presumed to reduce edema, on the success rate of nasolacrimal duct obstruction (NLDO) treatment by balloon dacryoplasty.

METHODS

The medical records of patients treated for NLDO using balloon dacryoplasty were reviewed retrospectively. Infants with <6 months' follow-up, genetic diseases, prior NLDO surgery, or anomalous nasolacrimal duct system were excluded. Patients either received intravenous dexamethasone perioperatively at a dose of 0.50 mg/kg (steroid group) or no dexamethasone (control group). Surgery was considered successful if there was no tearing or mucus discharge 1 month after surgery.

RESULTS

A total of 74 patients were included. In 71 eyes of 61 patients, dexamethasone was used; in 18 eyes of 13 patients, no dexamethasone. The mean age at treatment was 23.3 ± 15.6 months for the steroid group and was 22.5 ± 14.9 for the control group, with no difference between groups (P = 0.84). In the steroid group, 6 eyes (8.5%) had residual symptoms after surgery; in the control group 5 eyes (27.8%). There was a statistically significant higher success rate in the steroid group compared with the control group (P = 0.045; RR = 0.31 [95% CI, 0.11-0.9]).

CONCLUSIONS

In our study cohort, use of perioperative dexamethasone was associated with a reduced rate of failure in children treated for NLDO using balloon dacryoplasty.