PURPOSE: To compare the success rate of monocanalicular (MI) and bicanalicular intubation (BI) in congenital nasolacrimal duct obstruction (CNLDO). METHODS: MI through the inferior canaliculus and BI were performed under general anaesthesia in children from 7 to 24 months old with CNLDO. Only children after unsuccessful conservative therapy and two and more probings were included in the study. The tubes were removed 3 months after intubation and the therapeutic success was evaluated 6 months after intubation. RESULTS: There were performed 139 MI in 114 children and 119 BI in 88 children. The success rate 6 months after intubation is 135/139 (97.1%) in MI, 114/119 (95.8%) in BI and the difference in therapeutic results between MI and BI is not significant (p = 0.737). CONCLUSION: Silicone intubation is an effective procedure for treating CNLDO without difference in therapeutic success between MI and BI.Key words: congenital nasolacrimal duct obstruction (CNLDO), monocanalicular intubation (MI), bicanalicular intubation (BI).
- MeSH
- ductus nasolacrimalis abnormality chirurgie MeSH
- intubace metody MeSH
- kojenec MeSH
- konzervativní terapie MeSH
- lidé MeSH
- obstrukce slzovodu vrozené terapie MeSH
- předškolní dítě MeSH
- silikony MeSH
- stenty * MeSH
- výsledek terapie MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- silikony MeSH
The authors evaluated the successfulness of the conservative and intervention therapies combination in inborn lacrimal drainage system obstruction in a study group of 728 infants with 1154 eyes involved, treated at the Department of Ophthalmology, Faculty Hospital Královské Vinohrady (Kings Vineyards), Charles University, Prague, Czech Republic, E.U., during the period May 2004 - January 2011. The Fluoresceine Dye Dilution Test (FDDT) was used as the basic diagnostic test for the choice of the treatment procedure. The conservative therapy by itself, consisting of hydrostatic massages and application of germicide drops was helpful to canalize the lacrimal drainage system in 20 % of treated eyes, mostly in patients up to two months of age. The most of the patients (980 involved eyes), reached the Children outpatients of the Department of Ophthalmology at the age of approximately three months (average, 2.8 months). Since this age, the combination of the therapeutic irrigation with the probing, followed by the hydrostatic massages was indicated. The authors modified the probing technique according to their own experience gained during the endonasal intubation of the lacrimal drainage system by means of silicone tubing. At the phase of Bowmans probe entering the nasolacrimal sac, the probe was turned under the angle of 45 degrees to the vertical axis of the nose with simultaneous pressuring the probe against the orbital margin. By this procedure, the probe was introduced into the medial nasal meatus in the region of maxillary uncinate processus. Up to the end of the sixth month of age of the followed up infants, using the combination of conservative and intervention procedures, the lacrimal drainage system of 1036 eyes (90 %) was canalized. Out of 118 eyes with stenosis remaining even after 6 months of age, using the above-mentioned conservative therapy until the age of one year, 96 lacrimal drainage systems were further canalized. In the remaining 22 eyes (2 %) after the age of 1 year, the intubation of the lacrimal drainage system using the silicone tubing was performed. The total successfulness of our conservative intervention treatment strategy of lacrimal drainage system inborn obstruction up to the age of one year was 98 %.
- MeSH
- dítě MeSH
- ductus nasolacrimalis abnormality MeSH
- intubace normy MeSH
- kojenec MeSH
- léčebná irigace normy MeSH
- lidé MeSH
- obstrukce slzovodu vrozené terapie MeSH
- předškolní dítě MeSH
- směrnice pro lékařskou praxi jako téma * MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: To compare the success rate of monocanalicular intubation (MCI) compared with bicanalicular silicone intubation (BCI) in congenital nasolacrimal duct obstruction (CNLDO) in infants and toddlers. METHODS: In a prospective, nonrandomized, comparative study, MCI (n = 35 eyes) through the inferior canaliculus or BCI (n = 35 eyes) were performed under general anaesthesia in children aged 10 to 36 months with CNLDO. The tubes were removed 3-4 months after tube placement, and the children were followed up for 6 months after the removal of tubes. Therapeutic success was defined as the fluorescein dye disappearance test grade 0-1, corresponding with a complete resolution of previous symptoms. Partial success was defined as improvement with some residual symptoms. RESULTS: Complete and partial improvement was achieved in 31/35 (88.57%) in the BCI group and 34/35 (97.14%) in the MCI group. The difference between the two groups was not significant (p = 0.584). Complications occurred in both groups. Dislodgement of the tube and premature removal was observed in four BCI cases, and loss of the tube was observed twice in the MCI group. Canalicular slitting was observed in five eyes in the BCI group. Granuloma pyogenicum observed in 2 cases with MCI revealed a few weeks after the tube removal. Corneal erosion in the inferior medial quadrant was observed in one MCI eye and revealed in a few days after the local treatment without tube removal. CONCLUSIONS: Both MCI and the BCI are effective methods for treating CNLDO. MCI has the advantage of a lower incidence of canalicular slit and easy placement.
- MeSH
- celková anestezie MeSH
- ductus nasolacrimalis abnormality patofyziologie MeSH
- fluorescein metabolismus MeSH
- intubace metody MeSH
- kojenec MeSH
- lidé MeSH
- obstrukce slzovodu vrozené patofyziologie terapie MeSH
- odstranění implantátu MeSH
- pooperační komplikace MeSH
- předškolní dítě MeSH
- prospektivní studie MeSH
- silikonové elastomery * MeSH
- výsledek terapie MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- fluorescein MeSH
- silikonové elastomery * MeSH
