Outcomes of probing surgery and monocanalicular intubation for congenital nasolacrimal duct obstruction in children older than 18 months

Abstract

Congenital nasolacrimal duct obstruction is a prevalent condition in children. It is generally treated conservatively, but sometimes invasive therapies, such as nasolacrimal duct intubation, are required. In this study, we investigated the results of primary probing and nasolacrimal duct intubation in patients over the age of 18 months to determine the factors that led to failure and success. Method: 103 patients were included in this retrospective cohort study, and the success rate of nasolacrimal duct intubation in two types, Monoka and Masterka, was evaluated according to age during surgery, gender, type of intubation (Monoka or Masterka), type of probing (complex or simple), and previous history of probing. For data analysis, we utilized R and R Studio 2022.02.0 + 443. To calculate correlated eye data, we performed two-level survival analysis. Results: The final analysis included 98 patients with a total of 110 eyes. There were 12 patients who had bilateral eye involvement. The study group's average age was 41.46 months (range 18-108 months), with 54 (55.1%) males and 44 females. The average age of the present surgery was 21.46 months (95% confidence interval (CI): 14.79-28.14). The average period for surgical result follow-up was 98.37 days (95% CI: 109.1-87.65). Thirteen (11.8%) of the 110 eyes that underwent surgery were unsuccessful, while 97 (88.2) healed up. Both age and probing were statistically significant (P = 0.03, 0.006, respectively), while tube type was not (P = 0.08). Every month of age adds 2% to the failure rate. Despite the fact that this was not statistically significant in the frailty model when correlated eye data was used. Complex probing was found to be significantly related to a higher risk, procedures with complex probing failure were 6.2 times more likely than simple probing.