Dacryoendoscopy-assisted incision of Hasner’s valve under nasoendoscopy for membranous congenital nasolacrimal duct obstruction after probing failure: a retrospective study

Abstract

Background: To introduce a treatment option: dacryoendoscopy-assisted incision of Hasner’s valve under nasoendoscopy and assess its efficacy in treating membranous congenital nasolacrimal duct obstruction (CNLDO) in children older than 1 year with history of initial probing failure. Methods: 52 eyes of 43 children with membranous CNLDO who underwent dacryoendoscopy-assisted incision of Hasner’s valve under nasoendoscopy between May 2012 and October 2020 were enrolled in this retrospective study. All participants were older than 1 year and all the eyes had gone through probing at least once but still had symptoms of epiphora and discharge. Surgical success was defined as a normal fluorescein dye disappearance test (FDDT) and the absence of pre-operation complaints, including epiphora, muco-purulent discharge, increased tear lake or the symptoms of acute infection such as acute dacryocystitis. Patients’ demographics, clinical features and follow-up outcomes were evaluated. Results: Of all these operated cases, surgical success was achieved in 52/52 eyes without any early or late complications. The overall success rate was 100%. Conclusions: Dacryoendoscopy-assisted incision of Hasner’s valve under nasoendoscopy is an effective and minimally invasive surgical treatment in membranous CNLDO patients with initial probing failure.