Unprecedented complication in lacrimal system probing in children.
Author: Tamer Gawdat
Base Hospital / Institution: Professor of ophthalmology Cairo University
ePoster presentation
Abstract ID: 24-413
Purpose
To demonstrate a rare surgical complication happened to two children during lacrimal probing. Also to show methods of diagnosis and management.
Methods
Two patients presented to the Oculoplasty clinic after lacrimal probing in one side. The first presented with exotropia and defective ocular motility. The second patient presented with enophthalmos and mucopurlent discharge from the same operated side.
Results
Clinical and radiological examination revealed blow out fractures in both kids. The fracture involved both the medial wall and the floor of the orbit.The patient with enophthalmos has positive regurge as well. The first patient was managed with repair of the blow out fracture using an orbital implant. Forced duction test done to exclude any muscle entrapment. The second child underwent a DCR surgery with silicone tube implantation as a primary step then an orbital implant for the blow out fracture will be inserted later.
Conclusion
Probing for congenital nasolacrimal duct obstruction is a very common procedure. Although considered as a simple procedure yet it needs training and should be done in a proper way to avoid surgical complications.Common complications like canalcular cheese wiring or bleeding per nose are mentioned before. Blow out fractures are a very serious complications and to my knowledge this is the first time to be encountered post probing. Clinical and radiological examination after probing are essential if any ocular motility problems or an abnormal globe position are present postoperative. Proper management of such complication is mandatory to avoid further morbidities.
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