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ORIGINAL ARTICLE
Year : 2015  |  Volume : 63  |  Issue : 10  |  Page : 759-762

Factors affecting treatment outcome in congenital nasolacrimal duct obstruction: A retrospective analysis from South India


1 General Ophthalmology, Aravind Eye Hospital, Puducherry, India
2 Vitreo-retinal Services, Aravind Eye Hospital, Puducherry, India
3 Orbit and Oculoplasty Services, Aravind Eye Hospital, Puducherry, India
4 Medical School, Faculty of Medicine, University of Toronto, Ontario, Canada

Correspondence Address:
Dr. Sahil Bhandari
Aravind Eye Hospital, Cuddalore Main Road, Thavalakuppam, Puducherry - 605 007
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.171503

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Purpose: To investigate outcomes for different treatment modalities in congenital nasolacrimal duct obstruction (CNLDO) in an Indian population. Design: Retrospective, interventional, case series. Materials and Methods: In an institutional setting, case records of patients with CNLDO from January 2008 to 2012, were reviewed, and data on patient demographics, clinical presentation, and treatment details (sac massage, probing, and/or dacryocystorhinostomy) were recorded. Success of treatment was defined as complete resolution of symptoms and negative regurgitation on pressure over lacrimal sac (ROPLAS) area. Results: Two hundred and ninety-eight eyes of 240 patients with a mean age of 22.2 ± 26.14 months (median = 12 months, interquartile range = 17) were analyzed. Sac massage (n = 226) was successful in 67 eyes (30%). Multivariable logistic regression analyses showed that children with mucoid ROPLAS were almost 6 times more likely (odds ratio [OR] = 5.55 vs. clear ROPLAS, 95% confidence interval [CI] = 2.35-13.09, P < 0.001) to experience failure of sac massage. Overall probing (n = 193) was successful for 143 (74%) eyes. Multivariable logistic regression showed that older children were 25% more likely to experience probing failure (OR = 1.25 for every 6 months increment in age, 95%, CI = 1.09-1.42, P = 0.001). Conclusion: Sac massage is successful in only a third of our patients and those with mucoid ROPLAS are more likely to experience failure. Probing is successful in three-quarter of our subjects, and its success declines with a progressive increase in age. Lower socioeconomic status, poor general health, and recurrent respiratory infections are unique to our population and may influence outcomes.


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