The Characteristics of Infants with Congenital Nasolacrimal Duct Obstruction Iimproved with Lacrimal Sac Digital Massage

ABSTRACT

PURPOSE: The treatments for congenital nasolacrimal duct obstruction range from minimally invasive to more invasive methods. Initially, clinicians select lacrimal sac massage with topical antibiotics application or early lacrimal sac probing. We studied if the characteristics of infants improved after lacrimal sac massage with topical antibiotic application. METHODS: Two hundred thirty-four eyes of 204 patients diagnosed with congenital nasolacrimal duct obstruction from March 2001 to January 2007 were included. Excluded were infants who had obvious epiblepharon or eyelid abnormalities, tumors of the lacrimal system, or a history of trauma. Neonates less than 1 month were also excluded to rule out neonatal conjunctivitis. At the first visit, we recorded birth profile information such as gestational age, birth weight and height, onset time of symptoms, and post-conceptional age. We compared the results between the successful treatment group and failure group after lacrimal sac massage and topical antibiotic application. RESULTS: One hundred twenty-three eyes showed improvement after conservative treatment (52.6%), and the infants included in the success group visited earlier and had lower PCA (P<0.05). No other factors evaluated in this study contributed toward the improvement in symptoms observed. CONCLUSIONS: When considering treatment for congenital nasolacrimal duct obstruction, an evaluation of factors related to birth should be performed. According to the results, infants with the characteristics of favorable outcome should be treated conservatively, while those patients who do not have the characteristics for favorable outcome should be treated by early probing to achieve an effective and satisfactory outcome.