Congenital Nasolacrimal Duct Obstruction Update Study (CUP Study): Report III. Analysis of Earlier Failed Probing without Endoscopy Guidance

ABSTRACT

Aim

The purpose of this study was to report the profile and outcomes of children with an earlier failed probing that was performed without endoscopy guidance.

Methods

Retrospective interventional case study was performed on all the patients who were referred with a diagnosis of a single or multiple failed probing from Jan 2016 to June 2019 to a tertiary care Dacryology center. All the patients had a blind probing without an endoscopy assistance before referral. The parameters evaluated were patient demographics, number of earlier probings, prior operative notes, clinical presentation, findings of endoscopy guidance during the repeat procedure, simple vs complex CNLDO, types of complex CNLDO, management, complications and outcomes.

Results

One hundred eyes of 82 children had a failed probing experience without endoscopic guidance elsewhere. The mean age of the children was 55.7 months (range: 9–168 months). Of these, 63 eyes underwent repeat probing under endoscopic guidance, 35 eyes being simple CNLDO (35/63, 55.5%), and 28 eyes (28/63, 44.5%) being complex CNLDO. Among the complex subset, balloon dacryoplasty was performed for five cases and monoka-Crawford stents for eight cases under direct endoscopy visualization. Buried probes were managed successfully by standard protocols of probe exteriorization. The two cases of misdirected probes were re-directed under endoscopy guidance for appropriate recanalization and the single case of granuloma at the NLD opening was excised followed by intubation without any recurrence.

Conclusion

Endoscopy guidance plays a crucial role in the management of CNLDO with an earlier failed probing.

KEYWORDS:

• CNLDO
• Endoscopy
• Failed probing
• Lacrimal
• Balloon dacryoplasty

Financial Disclosure

Prof. Ali receives royalties from Springer for his treatise ‘Principles and Practice of Lacrimal Surgery’ (2nd ed) and ‘Atlas of Lacrimal Drainage Disorders’ and ‘Video Atlas of Lacrimal Surgery’.

Disclosure statement

The authors report no conflicts of interest