Journal of the Korean Ophthalmological Society 2002;43(12):2369-2374.
Published online December 1, 2002.
Systematic, Combined Treatment Approach to Nasolacrimal Duct Obstruction in Different Age Groups.
Soo Ho Cho, Mi Seon Kwak
Department of Ophthalmology, Daegu Fatima Hospital, Korea. MSKWAK66@orgio.net
선천성 비루관 폐쇄에 대한 단계별 치료의 효과
조수호 ( Soo Ho Cho ) , 곽미선 ( Mi Seon Kwak )
Abstract
PURPOSE
we studied the clinical outcome of a step-by-step treatment approach for congenital nasolacrimal duct obstruction (CNDO). METHODS: we analyzed 186 patients (222 eyes) who had been treated for CNDO between January 1996 and December 2000. According to age, conservative treatment, nasolacrimal duct probing and silicone intubation were applied systematically until a successful outcome was achieved. Patients were grouped according to their age at the time of first visit.: Group 1 (0~6 months), Group 2 (7~12 months), Gruop 3 (13~24 months), Group 4 (25~72 months). Treatment efficacy was determined according to age and success rate was compared. RESULTS: Conservative treatment was applied only in children less than 1 year of age and was successful in 75.9% of Group 1 and 47.3% of Group 2. The difference between these two success rates was significant (p=0.0001). The overall success rate for first probing in all groups was 65.2% with a range 75.8% in Group 1, 62.1% in Group 2, 65.0% in Group 3, and 40.0% in Group 4. After second probing, the overall cure rates for the entire cohort were 82.6% with a range 87.9% in Group 1, 89.7% in Group 2, 80.0% in Group 3, and 50.0% in Group 4. There was no real difference in first probing cure rate relative to age (p=0.208). But after second probing, overall cure rate was significantly decreased when the age of the patients was over 12 months (p=0.027). Silicone intubation was performed in 4 of Group 1, 3 of Group 2, 4 of Group 3, and 5 of Group 4 and was successful in all cases. CONCLUSIONS: Systematic treatment approach to CNDO including conservative treatment, nasolacrimal duct probing, and silicone intubation, was highly successful. In this study, the cure rate for this combined approach was 100% in 186 patients (222 eyes).
Key Words: Congenital nasolacrimal duct obstruction;Conservative treatment;Probing;Silicone intubation


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