Management of congenital nasolacrimal duct obstruction in children with Down Syndrome
Author: Nilay Yuksel
Base Hospital / Institution: Ankara City Hospital
ePoster presentation
Abstract ID: 24-444
Purpose
Describing the management of congenital nasolacrimal duct obstruction (CNLDO) in children with Down Syndrome (DS).
Methods
The medical records of the DS patients diagnosed with CNLDO during a 10-year period was retrospectively reviewed. The main outcomes included the surgical interventions, primary probing outcome, choice of secondary surgical intervention and overall surgical success.
Results
Forty-three eyes of 23 patients were included in the study. The mean age was 27.7±12.9 months. Seventeen patients (65%) had bilateral CNLDO. Mean follow-up time was 24.5±12.5 months. All eyes (43/43) underwent at least one surgical intervention. The most common primary surgical intervention was probing without silicone intubation in 41 of the eyes (95%). Abnormalities of the proximal lacrimal system were observed in 24 eyes (56%). 2 eyes had total punctual agenesis so that probing could not be performed. After primary surgical intervention, complete resolution was achieved in 19 eyes (44%), partial resolution was achieved in 6 eyes (14%), no improvement in symptoms was observed in 18 eyes (42%). Additional surgical interventions were recommended in the eyes where complete resolution was not achieved (24/43, 56%). Ritleng bicanalicular silicone intubation (RBSI) was recommended as a second surgical procedure in most eyes without complete resolution (18/24) and was performed in 14 of them. Dacryocystorhinostomy or conjunctivodacryocystorhinostomy was recommended in 6 eyes, but parents declined the procedure. Complete resolution was achieved in 11 of the 14 eyes (79%) in RBSI was performed, and partial resolution was achieved in 3 of them (21%). Overall, 30 of the 33 eyes (91%) that were compatible with the recommended treatment achieved complete resolution and the remaining 3 eyes (9%) improved in symptoms.
Conclusion
CNLDO in DS is associated with a high rate of bilateral obstruction and proximal abnormalities of the lacrimal system. The probing without intubation still seems to be a good and simple treatment option. RBSI could be successful in patients in whom probing has failed.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Asım Burak | Gündüz | Ankara City Hospital |
| Atike Burçin | Tefon Arıbaş | Ankara City Hospital |
