Outcomes of Lacrimal Sac Hydrostatic Pressure Application in Congenital Nasolacrimal Duct Obstruction
Author: Tal Koval
Base Hospital / Institution: Department of Ophthalmology, Edith Wolfson Medical Center, Holon, Israel and the School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
Rapid fire oral presentation
Abstract ID: 24-335
Purpose
Congenital Nasolacrimal Duct Obstruction (CNLDO) is a common ocular condition in infants, presenting with persistent epiphora and discharge that can interfere with the infant’s quality of life. Our study aims to assess the success rate of lacrimal sac Hydrostatic Pressure Application (HPA) maneuver, a conservative office procedure for treatment of CNLDO.
Methods
The medical records of pediatric patients, 36 months old or younger, diagnosed with CNLDO between the years 2016-2022, were retrospectively reviewed. In all children, HPA was performed by an ophthalmologist. Success was defined as the resolution of epiphora and discharge within 48 hours of the intervention.
Results
Two hundred and sixty-one eyes of 179 patients were included. Complete resolution of symptoms was achieved in 102 (39.1%) eyes. Patients six months old or younger at the time of HPA had a significant higher success rate compared to patients older than six months (43.7% vs 30.9%, p=0.04). Younger age at the time of pressure application was associated with a higher resolution rate of CNLDO (OR 0.93, p=0.004). Gender, prematurity, laterality of the obstruction and type of symptoms (epiphora, discharge) were not correlated with success. A second HPA was done in 46 eyes, with resolution of symptoms in 12 eyes (26.1%).
Conclusion
Hydrostatic pressure applied on the lacrimal sac by an experienced ophthalmologist may be an effective treatment for CNLDO. We recommend HPA as an initial active conservative approach in all pediatric patients with CNLDO, especially those younger than six months.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Ilanit | Trifonov | Department of Ophthalmology, Edith Wolfson Medical Center, Holon, Israel and the School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel |
| Ran | Moshkovsky | Department of Ophthalmology, Edith Wolfson Medical Center, Holon, Israel and the School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel |
| Oriel | Spierer | Department of Ophthalmology, Edith Wolfson Medical Center, Holon, Israel and the School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel |
