Effect of Probing in Congenital Nasolacrimal Duct Obstruction in Children Older Than 2 Years

Purpose: To determine the effect of probing for congenital nasolacrimal duct obstruction in children older than 2 years. Methods: A prospective interventional case series included 110 eyes of 94 patients with congenital nasolacrimal duct obstruction (CNLDO) aged 2 years or older, with no previous intervention. The diagnosis was based on clinical findings (epiphora, discharge, regurgitation test, and fluorescein dye disappearance test). The children were divided into two groups: 2 to 5 years and 6 to 8 years. Probing of the nasolacrimal duct under general anesthesia was done. Success was predefined as resolution of symptoms and signs that persisted 3 months postoperatively. Another probing was done at 4 to 6 weeks when necessary before considering the final outcome as a failure. The chi-square test was used to analyze the result. Results: Patients' ages ranged from 2 to 8 years (average age: 55 months). Twenty-six (28%) patients needed a second probing. The overall success rate was 80%: 85% in the 2 to 5 years group and 73% in the 6 to 8 years group. The success rate was significantly lower in patients with complex obstruction (33.3%). The outcome of probing was not affected by the age of the patients ( P = .2305). Conclusions: Probing is a viable primary surgical option in CNLDO in older children and hence should not be withheld in children who are referred late. [ J Pediatr Ophthalmol Strabismus . 2019;56(3):141–145.]