Outcome of late probing for congenital nasolacrimal duct obstruction in Singapore children.

OBJECTIVE

To evaluate the outcome of late probing in a mixed Asian children population with congenital nasolacrimal duct obstruction (CNLDO) and whether probing was associated with an increased risk of infection.

METHOD

A retrospective clinical study was conducted. A clinical diagnosis of CNLDO was defined in an infant who presented with a history of tearing and/or eye discharge up to 1 year of age with no other accompanying ocular pathology. All patients with a presumed diagnosis of CNLDO who had probing after 12 months of age were included in our study. Prior to probing, most patients had a trial of conservative treatment with massage and/or topical antibiotics. Intra-operative patency of probing was determined when metal to metal contact of the probe and forceps was achieved and/or when fluorescein dye was recovered from the nose after syringing. Successful probing was defined as a resolution of symptoms within 1 month after probing.

RESULTS

Seventeen patients involving 19 eyes fulfilled our inclusion criteria for this study. Fourteen (82%) infants were Chinese, two Malays (12%) and the remaining one Indian (6%). There were 10 males (59%) and 7 females (41%) and the mean age at probing was 2.2 years (range, 14 months to 5 years 6 months). The subjects were followed-up post-operatively for a mean duration of 21.2 months (range, 2 months to 8 years). Successful probing in our series was 89.5% (17/19 eyes). Of the two eyes with persistent tearing, one resolved with massage about 9 months after the unsuccessful probing; the other was referred to the oculoplastic service for further management.

CONCLUSION

Late probing after 13 months old appears to be an effective approach in the management of CNLDO in Asian infants.