Primary treatment of nasolacrimal duct obstruction with balloon catheter dilation in children younger than 4 years of age

J AAPOS. 2008 Oct;12(5):451-5. doi: 10.1016/j.jaapos.2008.07.001.


Purpose: To report the outcome of nasolacrimal duct balloon catheter dilation as the primary treatment of congenital nasolacrimal duct obstruction (NLDO) in children younger than 4 years of age.

Methods: One hundred two children (151 eyes) ages 12 to <48 months (mean, 23 months) at the time of surgery, who previously had not undergone a nasolacrimal surgical procedure and who presented with at least one of the following clinical signs of NLDO--epiphora, increased tear lake, and/or mucous discharge--were enrolled in a prospective, nonrandomized observational multicenter study (20 sites). All children received balloon catheter dilation of the nasolacrimal system of the affected eye(s).

Results: Treatment success was defined as no epiphora, increased tear lake, and/or mucous discharge present at the outcome visit at 1 month after surgery. The proportion of eyes treated successfully was 82% (95% CI: 74%-88%). The dye disappearance test at outcome was normal in 105 (73%), indeterminate in 15 (10%), and abnormal in 23 (16%) of the 143 eyes tested.

Conclusions: In children 12 to <48 months of age, balloon catheter dilation as a primary treatment of NLDO was successful in approximately 80% of cases. Because we did not perform a randomized trial with a comparison group, we were unable to determine how this procedure's success rate compares with that of simple probing or nasolacrimal intubation in this age group.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Catheterization*
  • Child, Preschool
  • Female
  • Fluorescein / pharmacokinetics
  • Fluorescent Dyes / pharmacokinetics
  • Humans
  • Infant
  • Lacrimal Apparatus Diseases / etiology
  • Lacrimal Duct Obstruction / complications
  • Lacrimal Duct Obstruction / therapy*
  • Male
  • Nasolacrimal Duct*
  • Prospective Studies
  • Quality of Life
  • Tears / metabolism
  • Treatment Outcome


  • Fluorescent Dyes
  • Fluorescein