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A prospective, randomised comparison of probing versus bicanalicular silastic intubation for congenital nasolacrimal duct obstruction.
Br J Ophthalmol. 2015 Feb; 99(2):246-50.BJ

Abstract

PURPOSE

To compare the success rates of probing versus bicanalicular silastic intubation as the primary treatment for congenital nasolacrimal duct obstruction (CNLDO) in children ≥1 year old.

STUDY DESIGN

Prospective, randomised, comparison.

METHODS

Participants were randomised to undergo probing or bicanalicular silastic intubation. In bilateral cases, the right eye was used for analysis. The procedure was considered successful when all preoperative manifestations disappeared with normal dye disappearance test and a positive Jones primary dye test at least 6 months postoperatively. Secondary outcomes were risk factors for failure. Outcomes were compared between treatments with p<0.05 indicating statistical significance.

RESULTS

207 eyes of 181 children between 1 and 8 years old with CNLDO who had not undergone previous surgical treatment were included in the study. 88 eyes underwent probing with a 84.1% success rate and 93 eyes that underwent bicanalicular silastic intubation had a 89.2% success rate (p=0.429). For simple CNLDO, there was a 94.2% (65/69) success rate with probing and a 90.9% (60/66) success rate with bicanalicular silastic intubation (p=0.687). In complex CNLDO, there was a 47.4% (9/19; p=<0.001) success rate with probing and an 85.2% (23/27; p=0.419) success rate with silastic intubation (p=0.016). Age was not a risk factor for failure in either procedure.

CONCLUSIONS

Probing for simple CNLDO in young children is adequate. Bicanalicular silastic intubation seems to have a role in achieving successful outcomes in complex CNLDO.

Authors+Show Affiliations

Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

25185252

Citation

Al-Faky, Yasser H., et al. "A Prospective, Randomised Comparison of Probing Versus Bicanalicular Silastic Intubation for Congenital Nasolacrimal Duct Obstruction." The British Journal of Ophthalmology, vol. 99, no. 2, 2015, pp. 246-50.
Al-Faky YH, Mousa A, Kalantan H, et al. A prospective, randomised comparison of probing versus bicanalicular silastic intubation for congenital nasolacrimal duct obstruction. Br J Ophthalmol. 2015;99(2):246-50.
Al-Faky, Y. H., Mousa, A., Kalantan, H., Al-Otaibi, A., Alodan, H., & Alsuhaibani, A. H. (2015). A prospective, randomised comparison of probing versus bicanalicular silastic intubation for congenital nasolacrimal duct obstruction. The British Journal of Ophthalmology, 99(2), 246-50. https://doi.org/10.1136/bjophthalmol-2014-305376
Al-Faky YH, et al. A Prospective, Randomised Comparison of Probing Versus Bicanalicular Silastic Intubation for Congenital Nasolacrimal Duct Obstruction. Br J Ophthalmol. 2015;99(2):246-50. PubMed PMID: 25185252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective, randomised comparison of probing versus bicanalicular silastic intubation for congenital nasolacrimal duct obstruction. AU - Al-Faky,Yasser H, AU - Mousa,Ahmed, AU - Kalantan,Hatem, AU - Al-Otaibi,Abdullah, AU - Alodan,Hessah, AU - Alsuhaibani,Adel H, Y1 - 2014/09/02/ PY - 2014/9/4/entrez PY - 2014/9/4/pubmed PY - 2015/4/1/medline KW - Embryology and development KW - Lacrimal drainage SP - 246 EP - 50 JF - The British journal of ophthalmology JO - Br J Ophthalmol VL - 99 IS - 2 N2 - PURPOSE: To compare the success rates of probing versus bicanalicular silastic intubation as the primary treatment for congenital nasolacrimal duct obstruction (CNLDO) in children ≥1 year old. STUDY DESIGN: Prospective, randomised, comparison. METHODS: Participants were randomised to undergo probing or bicanalicular silastic intubation. In bilateral cases, the right eye was used for analysis. The procedure was considered successful when all preoperative manifestations disappeared with normal dye disappearance test and a positive Jones primary dye test at least 6 months postoperatively. Secondary outcomes were risk factors for failure. Outcomes were compared between treatments with p<0.05 indicating statistical significance. RESULTS: 207 eyes of 181 children between 1 and 8 years old with CNLDO who had not undergone previous surgical treatment were included in the study. 88 eyes underwent probing with a 84.1% success rate and 93 eyes that underwent bicanalicular silastic intubation had a 89.2% success rate (p=0.429). For simple CNLDO, there was a 94.2% (65/69) success rate with probing and a 90.9% (60/66) success rate with bicanalicular silastic intubation (p=0.687). In complex CNLDO, there was a 47.4% (9/19; p=<0.001) success rate with probing and an 85.2% (23/27; p=0.419) success rate with silastic intubation (p=0.016). Age was not a risk factor for failure in either procedure. CONCLUSIONS: Probing for simple CNLDO in young children is adequate. Bicanalicular silastic intubation seems to have a role in achieving successful outcomes in complex CNLDO. SN - 1468-2079 UR - https://www.unboundmedicine.com/medline/citation/25185252/A_prospective_randomised_comparison_of_probing_versus_bicanalicular_silastic_intubation_for_congenital_nasolacrimal_duct_obstruction_ L2 - http://bjo.bmj.com/cgi/pmidlookup?view=long&amp;pmid=25185252 DB - PRIME DP - Unbound Medicine ER -