scholarly journals Outcome of probing and syringing in congenital nasolacrimal duct obstruction at various age groups in a tertiary eye center in Western Nepal

2018 ◽  
Vol 9 (6) ◽  
pp. 57-61
Author(s):  
Koshal Shrestha ◽  
Binita Bhattarai ◽  
Laxmi Devi Manandhar ◽  
Salma KC Rai ◽  
Arniko Pandey ◽  
...  
Keyword(s):  
Invasive Procedure ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Successful Outcome ◽  
Optimal Time ◽  
Cross Sectional ◽  
Female Ratio ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Primary Treatment Modality

Background: Congenital nasolacrimal duct obstruction (CNLDO) is one of the commonest problems encountered in daily ophthalmology practice. Though probing and syringing is the mainstay of management of CNLDO, there is no clear guideline about the optimal time to perform.Aims and Objective: To evaluate the efficacy of probing and syringing in cases of congenital nasolacrimal duct obstruction in various age groups.Materials and Methods: In this prospective, hospital based, interventional, cross-sectional study done over a period of 2 years (July 2015- June 2017), children of various age ranging from 10 days to 8 years who underwent probing and syringing under general anesthesia for CNLDO refractory to conservative measures were included. Results: Children of as young as 10 days to as older as 8 years underwent probing and syringing with male to female ratio of 1.2:1. Overall success was 80.6% (58/72) which was statistically significant when analyzed with age (P = 0.006). Majority of cases with successful outcome were below 24 months of age (90.62%). There was predominance of membranous obstruction (128/194) over bony obstruction (66/194). Conclusions: Nasolacrimal duct probing under GA is a safe and viable option as a primary treatment modality for CNLDO. Though the success of probing is high in the younger children, it’s worthwhile to consider the same in older children at least up to 5 years of age before going for more invasive procedure like DCR surgery since more than 2 third of probing has successful outcome up to that age.Asian Journal of Medical Sciences Vol.9(6) 2018 57-61

scholarly journals Prevalence of Congenital Nasolacrimal Duct Obstruction and its related risk factors among newborns

2021 ◽  
pp. 158-165
Keyword(s):  
Risk Factors ◽  
Drainage System ◽  
Cross Sectional Study ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Common Symptom ◽  
Related Factors ◽  
Cross Sectional ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction

Introduction: Lacrimal drainage system disorders are among the most common ocular disorders faced by physicians. The prevalence of congenital nasolacrimal duct obstruction (CNLDO) is different in various studies, and the role of such factors as maternal and neonatal demographic characteristics have not been completely investigated in CNLDO. The present study aimed to assess the prevalence of CNLDO and its related factors in newborns in Sabzevar. Methods: This cross-sectional study was conducted on 541 newborns in Shahidan Mobini hospital, Sabzevar, Iran from January to February 2015 after obtaining informed consent from their parents. Data were collected by interviewing mothers, filling out checklists, and physical examination of the newborns. Data analysis was carried out in Stata software using a logistic regression test at a 95% confidence interval. Results: The prevalence of CNLDO was 22.6%. Purulent ocular discharge was the most common symptom (16.82%). There was a significant relationship between the neonate’s head circumference and the incidence of CNLDO (P= 0.01); nonetheless, CNLDO in the newborns showed no significant association with weight, height, and Apgar score (P>0.05). Conclusion: Considering the significant prevalence of CNLDO in preterm and term neonates, as well as its variable prevalence rates reported in different studies and the absence of overlapping of various risk factors of such disorder, it is recommended to carry out more thorough studies from birth to 1 year of age.

scholarly journals Lacrimal Sac Bacteriology and Susceptibility Pattern in Infants with Congenital Nasolacrimal Duct Obstruction in the 1st Year of Life: A Cross-Sectional Study

2020 ◽  
Author(s):  
Xiaoyu Zheng ◽  
Bonnie Nga Kwan Choy ◽  
Mingming Zhou ◽  
Caiping Shi ◽  
Zhengyan Zhao
Keyword(s):  
Tertiary Care ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
First Year ◽  
Lacrimal Sac ◽  
Gram Positive ◽  
Cross Sectional ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Gram Negative ◽  
Duct Obstruction

Abstract Background Congenital nasolacrimal duct obstruction (CNLDO) is one of the main causes of epiphora in infants, and antibiotics are usually used as a conservative therapy in the first year. Yet, little is known about the bacteriology of the occluded lacrimal drainage system in this group of patients. The aim of this study was to evaluate the microbiology of lacrimal sac (LS) in Chinese children with CNLDO in their first year of life. Methods Patients with CNLDO between May 1, 2017 and August 31, 2018 at a tertiary care children’s hospital were enrolled. The study recruited infants who received lacrimal probing under 1 year old, and refluxed discharge from LS was collected. Samples were cultured and susceptibility test was performed for positive culture. Results Thirty-two patients with CNLDO were included. The ratio of male to female was 1.5 : 1. The mean age was 6.6 ± 2.3 (1.7–12) months. Positive cultures was identified in 87.5% of the sample, and presented 38 strains of bacteria. Mixed infection was identified in 10 (35.7%) children. Gram-positive bacteria accounted for 60.5% of all the strains, with Streptococcus (50%) being the most frequent species, whereas Haemophilus (21.1%) and Neisseriae (13.2%) were most common isolates for Gram-negative organisms. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 2 infants whose symptoms resolved by a routine probing. No difference of bacteriology pattern was detected between patients under 6 months old and those beyond. The pathogens were highly sensitive to chloramphenicol (88%) and levofloxacin (84%), but resistant to erythromycin (40%) and sulfamethoxazole (32%). Conclusions Infants with CNLDO under 1 year of age presented predominance of Streptococcus as Gram-positive organism, and Haemophilus as Gram-negative organism. Levofloxacin was an active topical antibiotic agent with few chance of resistance. These findings could help clinicians choose optimal medicine for CNLDO as the conservative treatments.

scholarly journals Endoscopic DCR with and without prolene stent in rural area: a prospective randomized study

2018 ◽  
Vol 4 (4) ◽  
pp. 1081
Author(s):  
Abhay Kumar ◽  
Prateek Kumar Porwal ◽  
Kailash Prasad Dubey ◽  
Harshita Singh
Keyword(s):  
Randomized Study ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Successful Outcome ◽  
Endoscopic Endonasal ◽  
Female Ratio ◽  
Duct Obstruction ◽  
Chronic Dacryocystitis ◽  
Endonasal Dcr ◽  
Endoscopic Dcr

<p class="abstract"><strong>Background:</strong> The objective of the study was<strong> </strong>to compare the results of endoscopic DCR with and without prolene stenting and to assess subjective and anatomical success in patients undergoing prolene stenting.</p><p class="abstract"><strong>Methods:</strong> The surgical outcomes of endoscopic endonasal DCR was compared in 100 patients of chronic dacryocystitis with nasolacrimal duct obstruction from June 2013 to May 2018. The successful outcome of surgery was defined by subjective improvement of symptoms and anatomical patency of the neo-ostium on syringing by nasal endoscopy.  </p><p class="abstract"><strong>Results:</strong> In our study females were predominant in both groups with around 60% being females in group with stenting and 64% in group without stenting. Male to female ratio was 1:1.5 and 1:1.77 in group with stenting and without stenting. The symptomatic success rate of the surgery at the end of 3 months was 92% in group without stenting and 88% in group with stenting. There was no statistical difference in the results of two groups.</p><p><strong>Conclusions:</strong> We recommend that stenting is not routinely required for endoscopic DCR surgeries. A selective stenting approach may be advocated using prolene 3-0, using stenting for specific indications. With proper surgical technique and good follow up, endoscopic DCR without stenting is treatment of choice for chronic nasolacrimal duct obstruction.</p>

Spontaneous resolution rates in congenital nasolacrimal duct obstruction managed with massage or topical antibiotics compared with observation alone

2021 ◽  
pp. bjophthalmol-2021-318853
Author(s):  
Brian G Mohney ◽  
Saraniya Sathiamoorthi ◽  
Ryan D Frank
Keyword(s):  
Medical Records ◽  
Population Based ◽  
Nasolacrimal Duct ◽  
Spontaneous Resolution ◽  
Nasolacrimal Duct Obstruction ◽  
Olmsted County ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Topical Antibiotics

Background/aimsTo determine if nasolacrimal massage or topical antibiotics are associated with higher rates of resolution compared with observation alone in a population-based cohort of infants with congenital nasolacrimal duct obstruction (CNLDO).MethodsThe medical records of all children <5 years diagnosed with CNLDO while residing in Olmsted County, Minnesota from 1 January 1995 through 31 December 2004 were retrospectively reviewed for type of management and non-surgical resolution of tearing.ResultsAmong 1958 infants diagnosed and followed for CNLDO, 516 (26.4%) were merely observed, 506 (25.8%) were prescribed massage alone, 485 (24.8%) were prescribed at least one course of topical antibiotics, 397 (20.3%) were prescribed both topical antibiotics and massage, and 54 (2.8%) had no documented therapy. Non-surgical resolution, occurring in 1669 (85.2%) during a median follow-up of 3.1 months (range: 1 week–248 months), was 74.6% for the merely observed, 89.7% for those prescribed digital massage, 87.0% for those prescribed antibiotics and 90.7% for those treated with both. This comparison was significant in unadjusted (p<0.001) and multivariable comparisons (p<0.001).ConclusionPrescribing topical antibiotics or digital massage for infants with CNLDO in this cohort, individually or in combination, was associated with a higher rate of spontaneous resolution than observation alone.

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