Clinical Efficacy of Lacrimal Endoscopy in Patients with Epiphora

PURPOSE: To evaluate the clinical efficacy of lacrimal endoscopy in patients with nasolacrimal duct obstruction (NLDO) and to compare the dacryocystography (DCG) and lacrimal endoscopic findings between patients with epiphora. METHODS: We conducted a retrospective chart review of 31 eyes of 23 patients who underwent an irrigation test, DCG, and lacrimal endoscopy from December 2014 to February 2016. We compared the clinical characteristics, and dacryocystographic findings, and lacrimal endoscopic findings of the patients, and analyzed whether or not these findings agree. RESULTS: Thirty-one eyes showed complete obstruction (13 eyes, 41.9%), partial obstruction (7 eyes, 22.6%), or patency (11 eyes, 35.5%) on irrigation test. Thirteen eyes with complete obstruction on irrigation test presented with complete obstruction (11 eyes, 84.6%) or secondary dilation (2 eyes, 15.4%) of the lacrimal sac at DCG. In terms of the level of obstruction, there was no difference between the two examinations. However, twelve eyes with complete obstruction at DCG; showed narrowing (4 eyes, 33%), granulation tissue (3 eye, 25%), mucus occlusion (2 eyes, 17%), stones (1 eye, 8%), or mucosal edema (2 eyes, 17%) on lacrimal endoscopy. Nineteen eyes with partial obstruction at DCG showed narrowing (6 eyes, 32%), mucus (5 eye, 26%), granulation tissue (4 eyes, 21%), or stones (4 eyes, 21%) on lacrimal endoscopy. CONCLUSIONS: Lacrimal endoscopy allowed real-time observation inside the lacrimal passage that cannot be detected using DCG. Both methods provide comprehensive investigations of the nasolacrimal passage system, and these methods are complementary to understand the pathophysiology of nasolacrimal duct obstruction as well as planning treatment. Lacrimal endoscopy is very useful in investigating the lacrimal drainage passage in patients with NLDO, and this method is comparable to DCG.

Clinical Outcomes of Probing in Children with Congenital Nasolacrimal Duct Obstruction

PURPOSE: To determine the success rate of probing for the treatment of congenital nasolacrimal duct obstruction and to identify the clinical factors affecting the success rates. METHODS: The records of probing procedures from January 2005 to January 2015 were reviewed. The present study included 200 eyes of 174 patients with congenital nasolacrimal duct obstruction. Successful probing was defined as complete resolution of epiphora 3 months after treatment. Success rates were compared between the 2 groups in terms of sex, age, laterality, and previous probing. RESULTS: A total of 200 eyes of 174 children (109 eyes of 94 males and 91 eyes of 80 females; mean age, 7.51 ± 3.39 months) had undergone the probing procedure. The overall success rates of primary probing were 81.5%, with an 80.7% success rate in males (88 eyes of 109 eyes) and 82.5% in females (75 eyes of 91 eyes). Success rates were 83.5% for the 91 eyes in children aged 0 to 6 months, 80.0% for the 90 eyes in children 6 to 12 months, and 78.9% for the 19 eyes in children over 12 months. No statistical significances were found among age groups. The probability of treatment success was lower in bilateral disease (p < 0.05; 86.4-67.3%). Twenty-four of 37 eyes with unsuccessful primary probing underwent secondary probing, resulting in a 70.8% success rate. Silicone tube insertion was performed in 4 eyes repeatedly, however, the procedures were unsuccessful. The overall success rate was 90%. CONCLUSIONS: The success rates among various age groups were not statistically significant. The probability of treatment success was lower in bilateral cases. Probing is an effective first-line treatment in children diagnosed with nasolacrimal duct obstruction. Close observation and appropriate treatment should be considered in patients with bilateral disease.

Clinical Outcomes of Probing in Children with Congenital Nasolacrimal Duct Obstruction

PURPOSE: To determine the success rate of probing for the treatment of congenital nasolacrimal duct obstruction and to identify the clinical factors affecting the success rates. METHODS: The records of probing procedures from January 2005 to January 2015 were reviewed. The present study included 200 eyes of 174 patients with congenital nasolacrimal duct obstruction. Successful probing was defined as complete resolution of epiphora 3 months after treatment. Success rates were compared between the 2 groups in terms of sex, age, laterality, and previous probing. RESULTS: A total of 200 eyes of 174 children (109 eyes of 94 males and 91 eyes of 80 females; mean age, 7.51 ± 3.39 months) had undergone the probing procedure. The overall success rates of primary probing were 81.5%, with an 80.7% success rate in males (88 eyes of 109 eyes) and 82.5% in females (75 eyes of 91 eyes). Success rates were 83.5% for the 91 eyes in children aged 0 to 6 months, 80.0% for the 90 eyes in children 6 to 12 months, and 78.9% for the 19 eyes in children over 12 months. No statistical significances were found among age groups. The probability of treatment success was lower in bilateral disease (p < 0.05; 86.4-67.3%). Twenty-four of 37 eyes with unsuccessful primary probing underwent secondary probing, resulting in a 70.8% success rate. Silicone tube insertion was performed in 4 eyes repeatedly, however, the procedures were unsuccessful. The overall success rate was 90%. CONCLUSIONS: The success rates among various age groups were not statistically significant. The probability of treatment success was lower in bilateral cases. Probing is an effective first-line treatment in children diagnosed with nasolacrimal duct obstruction. Close observation and appropriate treatment should be considered in patients with bilateral disease.