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Congenital lacrimal fistula associated with Down syndrome

  • Oculoplastics and Orbit
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Abstract

Background

The aim of this work is to investigate the prevalence and clinical characteristics of congenital lacrimal fistula in Down syndrome patients.

Methods

The medical records of 198 Down syndrome patients who were referred to a tertiary ophthalmology clinic from 2000 to 2010 were retrospectively reviewed to identify patients with congenital lacrimal fistula. The demographic data, clinical features, clinical management, and clinical outcomes were recorded. The main outcome measures were the presence and laterality of fistula, accompanying adnexal and oculomotor abnormalities including congenital nasolacrimal duct obstruction (NLDO), the type of surgery performed, and surgical outcome. The prevalence of congenital lacrimal fistula in Down syndrome patients was calculated upon this data.

Results

Congenital lacrimal fistula was identified in 8/198 (4.04 %) patients, 4 (2.02 %) of whom presented with bilateral lacrimal fistula. All patients that had lacrimal fistula complained of tearing from their eyes. Congenital NLDO was observed in seven of eight patients with lacrimal fistula. Five patients underwent excision of the lacrimal fistula for the improvement of cosmesis, and three of these patients also underwent lacrimal silicone intubation for NLDO. Another patient received lacrimal silicone intubation for NLDO without excision of the lacrimal fistula. Excision of the lacrimal fistula was successful in all patients; however, tearing persisted after surgery in two patients with uncorrected NLDO.

Conclusions

Congenital lacrimal fistula occurs more frequently in Down syndrome patients and therefore these patients should be thoroughly examined for this abnormality. Down syndrome patients with congenital lacrimal fistula should be also examined for NLDO, because this condition is frequently observed in these patients.

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Acknowledgments

The authors indicate no financial support or no conflict of interest.

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Authors and Affiliations

  1. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea

    Sangmoon Lee & Sang In Khwarg

  2. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, #300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, Korea

    Namju Kim

  3. Department of Ophthalmology, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea

    Ho-Kyung Choung

  4. Department of Ophthalmology, Hallym Sacred Heart Hospital, Anyang, Korea

    Min Joung Lee

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  1. Sangmoon Lee
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  2. Namju Kim
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  3. Sang In Khwarg
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  4. Ho-Kyung Choung
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  5. Min Joung Lee
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Corresponding author

Correspondence to Namju Kim.

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All authors have full control of all primary data and agree to allow Graefes Archive for Clinical and Experimental Ophthalmology to review author’s data upon request.

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Lee, S., Kim, N., Khwarg, S.I. et al. Congenital lacrimal fistula associated with Down syndrome. Graefes Arch Clin Exp Ophthalmol 250, 1515–1519 (2012). https://doi.org/10.1007/s00417-012-2081-x

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  • DOI: https://doi.org/10.1007/s00417-012-2081-x

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