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Pediatric nasolacrimal duct obstruction a review of current management


Advances in Ophthalmology & Visual System
Ahmad Aziz,1 Vickie Lee,1 Tessa Fayers,1 Yassir Abourayyah,2 Rajni Jain2

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Abstract

Purpose: Congenital nasolacrimal duct obstruction is a common condition that is treated conservatively. There are varying reports on when to consider intervention. The aim of this study is assess when intervention is performed in England on the National Health Service and to review the opinions of Oculoplastic surgeons in the United Kingdom.

Methods: A survey was sent by email to 130 oculoplastic surgeons with 10 closed questions on syringing and probing and dacryoscystorhinostomy in pediatric cases and responses were analysed. C25 and C27 National Health Service codes in England were looked at from the period of 2012-2016 which cover syringing and dacryocystorhinostomy and syringing and probing procedures respectively. Total admissions coded for these procedures were looked at covering age groups from 0 to 18 years.

 

Results: A mean of 1607 syringing and probing procedures during 2012-2016 periods with the most common age group was being those in the 1-4 year age group. A minority were performed in those aged less than 1 year. Oculoplastic surgeons would commonly consider syringing and probing in the 1-2 year age group consistent with current evidence. Dacryocystorhinostomy is most commonly performed in the 1-4 age group with the majority performed in the 1-14 age group overall. The highest number of revision dacryocystorhinostomy procedures were performed in the the 1-9 age group.

 

Conclusion: The majority of syringing and probing procedures were performed over the age of 1 year constant with current evidence. There are a substantial number of oculoplastic surgeons that would consider endonasal dacryocystorhinostomy in pediatric cases although the current preference is for an external approach. Revision dacryocystorhinotomy most commonly occurs in the 1-9 age group.

Keywords

congenital nasolacrimal duct obstruction, dacryocystorhinostomy, lacrimal sac, canaliculodacryocystorhinostomy

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