Late and very late initial probing for congenital nasolacrimal duct obstruction: what is the cause of failure?

Br J Ophthalmol. 2003 Sep;87(9):1151-3. doi: 10.1136/bjo.87.9.1151.


Aims: To find the cure rate of late (second year of age) and very late (3-5 years of age) initial probing for congenital nasolacrimal duct obstruction (CNLDO) and to identify the factors contributing to the failure rate of the probing in older children.

Methods: In a prospective interventional case series study, 169 eyes of 125 consecutive patients (1-5 years old) with CNLDO underwent probing under general anaesthesia. Cure was defined as absence of tearing and discharge in the affected eye.

Results: 138 eyes of 101 patients aged 13-60 months (mean 23.4 (SD 10.2)) were included. Of 15 eyes (10.8%) with complex CNLDO, 80% presented after 24 months of age (p<0.0001). The cure rate was 89% in patients 13-24 months of age and 72% after the age of 24 months (p = 0.01). It was 90.2% in the membranous and 33.3% in the complex CNLDO in both late and very late probing (p<0.0001). There was a high correlation (r = 0.97) and no significant difference between the cure rate at 1 week and final follow up.

Conclusion: Accumulation of the complex CNLDO is the main risk factor for failure of probing in the older children. The outcome of the nasolacrimal duct probing at 1 week follow up is highly indicative of the final outcome.

MeSH terms

  • Age Factors
  • Child, Preschool
  • Dacryocystitis / etiology
  • Dacryocystitis / surgery
  • Dacryocystorhinostomy
  • Female
  • Humans
  • Infant
  • Lacrimal Duct Obstruction / congenital*
  • Male
  • Nasolacrimal Duct*
  • Postoperative Care / methods
  • Prospective Studies
  • Regression Analysis
  • Treatment Failure