Conservative treatment for congenital nasolacrimal duct obstruction - Factors affecting the success

Abstract

Aim: To examine the success rate and factors affecting the effect of conservative treatment for congenital nasolacrimal duct obstruction (CNLDO) in children. Methodology: A prospective study was made on 167 eyes of 131 patients with clinical signs of CNLDO. All of them were initially treated nonsurgically with Crigler massage. The curative effect of this management was evaluated on the basis of no history of watery eyes, negative regurgitation test, and dye disappearance test 0 or 1 grade. Exploratory analyses assessed whether baseline characteristics including age, gender and laterality were associated with the probability of CNLDO resolving without surgery. If the nonsurgical treatment failed, probing was done in the Eye Clinic in Pleven. Results: The conservative treatment for CNLDO with Crigler massage was successful in the majority of treated cases - in 115 out of 167 eyes with CNLDO (68,9%). The remaining 52 (31,1%) eyes were probed. Age (p = 0,001) and laterality (p = 0,001) were found to be associated with resolution of the clinical signs. Conclusions: Nonsurgical management for CNLDO was successful initial treatment in patients with this pathology. The Crigler massage was more effective in children up to 12 months of age with unilateral obstruction.