Abstract
Purpose
To determine the outcome of dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction (NLDO) in children.
Methods
A review of medical records of 104 cases (82 patients) of paediatric DCR who underwent DCR at the Sydney Eye Hospital from 1995 to 2004. The main outcome measures included post-operative symptomatic relief of presenting symptoms, complications, subjective visibility of any scar, and general satisfaction. Statistical methods included χ2 tests, and Student's t-tests for the comparison of variables among groups.
Results
Ninety-four external, 10 endoscopic primary procedures, and five revision procedures were included. Fifty-six of the cases were primary NLDO, and 48 were secondary NLDO. The mean follow-up was 1.44 years. Average age at surgery was 6.6±4.2 years (mean±SD). Ninety-one eyes needed DCR for the involvement of the lower lacrimal outflow system, and 13 eyes were NLDO associated with congenital punctual/canalicular dysgenesis.
Most of the complications of external DCR were related to Jones tube placement. Five cases (4.8%) needed DCR revision. There was a significantly higher incidence of revision surgery in the non-stented group (P<0.01), and the Jones tube group (P<0.001) as compared with the silicone intubation stent group.
Conclusions
External DCRs have acceptable long-term clinical and cosmetic results, and low post-operative complication rate. Cases with punctal stenosis or those requiring Jones tube insertion are associated with a higher complication rate. Silicone intubation is associated with a lower need for operative revision.
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The authors have no financial interest in any of the materials used in this study
The addresses of the institutions at which the work was carried out: Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital, Macquarie Street, Sydney, NSW 2000, Australia
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Nemet, A., Fung, A., Martin, P. et al. Lacrimal drainage obstruction and dacryocystorhinostomy in children. Eye 22, 918–924 (2008). https://doi.org/10.1038/sj.eye.6702769
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DOI: https://doi.org/10.1038/sj.eye.6702769
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