Abstract Listings 2024

Purpose

Congenital nasolacrimal duct obstruction (CNLDO) is a pediatric disorder with a wide range of pathology. If untreated, the condition may end up with serious complications. Multiple treatment options for CNLDO exist throughout the literature, and there is an ongoing debate on the best intervention for each disease subgroup and the best timing of such interventions. This study compares the success and failure rates of silicone tube intubation (STI) against probing and balloon dilation (BD).

Methods

We searched the literature for relevant articles using PubMed, Scopus, web of Science, and Cochrane Library until January 2024. Using RevMan 5.4, we compared STI’s success and failure rates to probing and balloon dilation using risk rations and a random effects model. In addition, the complication rate of monocanalicular (MCI) vs bicanalicular intubation (BCI) was investigated. We used the leave-one-out method to check for influential studies and to resolve heterogeneity.

Results

The screening process resulted in 23 eligible articles for inclusion in our review. STI had a higher chance of resolving the symptoms of CNLDO than probing (Risk Ratio= 1.11; 95%CI [ 1.04, 1.20]; p-value: 0.004) while having less risk of surgical failure (RR= 0.48; 95% CI [ 0.30, 0.76]; p-value: 0.002). MCI showed no statistically significant difference when compared to BCI in terms of surgical success and failure; however, MCI had a lower risk of complications (RR= 0.68; 95% CI [0.48, 0.97]; p-value: 0.04). Additionally, STI did not demonstrate any significant difference from BD.

Conclusion

There was no significant difference in success/failure between monocanalicular and bicanalicular intubation; monocanalicular had fewer complications. Silicone tube intubation did better in terms of surgical success than probing, especially in children over 12 months, suggesting that it is the preferred intervention for older CNLDO patients.

Additional Authors

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