Repetitive probing identifies nasolacrimal duct obstructions

Repetitive probing with intranasal endoscopic imaging provides information about congenital nasolacrimal duct obstructions, claims a paper in the European Journal of Ophthalmology.

Dr S. Okumus et al., Department of Ophthalmology, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey, included 84 eyes of 64 patients who experienced unsuccessful primary probing. Each patient was divided into three groups according to the number of unsuccessful probing attempts. Group one included 50 eyes who experienced one unsuccessful probing, group two consisted of 23 eyes with two unsuccessful probings and group three had 11 eyes that underwent three.

History taking, clinical examination and fluorescence disappearance test confirmed the diagnosis of congenital nasolacrimal duct obstruction. Nasal endoscopic-assisted probing was performed in all eyes. All patients were followed-up on the first week, first month and third month, postoperatively.

The reasons for failure, as determined by endoscopy, were functional insufficiency in 8.3% of patients, lower nasal concha tension in 4.7%, thin membrane in Hasner valve in 3.6%, thick membrane and fibrosis in the distal side of the duct in 21.4%, probe progressed submucosally on the nasal wall in 33.3%, different exit location in the nose in 20.2%, nasal mucosa ballooning in the distal side of the duct in 4.7%, mucocele in 2.4% and nasal polyposis in 1.2%.

The predicted success rates for groups one, two and three were 86%, 69.5% and 54.5%, respectively. Repetitive probings via nasal endoscopy was able to provide information on the location and shape of the obstruction.

Please click here to read the abstract.