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Efficacy of probing for children with congenital nasolacrimal duct obstruction: a retrospective study using fluorescein dye disappearance test and lacrimal sac echography

  • Pediatrics
  • Published:
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Abstract

Purpose

To evaluate B-scan echography for the assessment of lacrimal sac (LS) in pediatric epiphora secondary to congenital nasolacrimal duct obstruction (CNLDO), and to verify its predictive role in functional efficacy of nasolacrimal duct probing.

Patients and Methods

Thirty-nine eyes of 23 consecutive children, treated with a single probing for persistent CNLDO-related epiphora, were retrospectively studied. These cases were investigated both collectively and considering two sub-groups: group A (ten patients [20 eyes] ≤13 months) and group B (13 patients [19 eyes] >13 months. Fluorescein dye disappearance test at 10 minutes (FDDT-10) and ultrasound examination of LS were performed before and after probing. An echographic LS scoring system (grade 0 = no LS enlargement; grade 1 = slight longitudinal LS enlargement; grade 2 = longitudinal and slight transverse LS enlargement; grade 3 = marked longitudinal and transverse LS enlargement) was introduced as a predictor of probing efficacy, estimating FDDT-10 modification between pre- and post-operative checks.

Results

Echographic LS evaluation was easily practicable without sedation. In the total cluster and in both age sub-groups, post-probing FDDT-10 decreased with respect to pre-probing value (p < 0.001). Post-probing LS score improved with respect to pre-probing check within the total cluster and group A (p < 0.05). Strong correlation between pre-probing LS alteration and functional probing failure was present in each studied cluster (all p values <0.0001). Within group B, a greater gain of post-probing FDDT-10 was more frequent in patients with a better pre-probing LS score, as well as in younger children (both p values <0.0001).

Conclusions

In children with CNLDO-related epiphora, B-scan echography of the LS can represent a reliable and useful examination for a better understanding of the functional prognosis after probing treatment.

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Acknowledgements

We thank Ms. Graziella Ferraresi for her logistic support, and the parents of the babies for their cooperation.

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No conflicting relationship exists for any author.

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Authors and Affiliations

  1. Unit of Ophthalmology, ULSS 15 Alta Padovana, Camposampiero Hospital, Camposampiero, Italy

    Piero Steindler & Enrico Mantovani

  2. Department of Ophthalmology, University of Ferrara, Ferrara, Italy

    Carlo Incorvaia & Francesco Parmeggiani

  3. Sezione di Clinica Oculistica, Dipartimento di Discipline Medico-Chirurgiche della Comunicazione e del Comportamento, Università degli Studi di Ferrara, Corso Giovecca 203, 44100, Ferrara, Italy

    Francesco Parmeggiani

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  1. Piero Steindler
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  2. Enrico Mantovani
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  4. Francesco Parmeggiani
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Correspondence to Francesco Parmeggiani.

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The authors have full control of all primary data, and they agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review their data upon request.

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Steindler, P., Mantovani, E., Incorvaia, C. et al. Efficacy of probing for children with congenital nasolacrimal duct obstruction: a retrospective study using fluorescein dye disappearance test and lacrimal sac echography. Graefes Arch Clin Exp Ophthalmol 247, 837–846 (2009). https://doi.org/10.1007/s00417-008-1022-1

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  • DOI: https://doi.org/10.1007/s00417-008-1022-1

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