Balloon catheter dilatation for treatment of congenital nasolacrimal duct obstruction.

PURPOSE: To determine the efficacy of balloon catheter dilatation to treat congenital nasolacrimal duct obstruction in children over 12 months of age and in children who had failed lacrimal system probing or silicone intubation.
METHODS: We performed a prospective study of balloon catheter dilatation for congenital nasolacrimal duct obstruction in 61 lacrimal systems of 51 patients with an age range of 13 to 73 months (mean, 26 months). Twenty-seven lacrimal systems (44.3%) had no previous procedures, 21 lacrimal system (34.4%) had one or more failed probings, and 13 lacrimal system (21.3%) had failed silicone intubation. Infection was eliminated or suppressed preoperatively with a ten-day course of systemic and topical antibiotics. Oral and topical antibiotics were continued for ten days after surgery. Oral prednisone was administered for five days after surgery. One percent prednisolone acetate eyedrops were for ten days after surgery. Patency was defined as absence of tearing or discharge after the sixth postoperative week, a lack of discharge and a normal tear meniscus on examination, and a normal dye disappearance test.
RESULTS: Twenty-six (96%) of the 27 lacrimal drainage systems that had balloon catheter dilatation as a primary procedure were patent after surgery. Thirty-two (94%) of the 34 lacrimal drainage systems that had undergone previous probing or silicone intubation were patent after balloon catheter dilatation. Overall, 58 (95%) of 61 lacrimal drainage systems were patent after balloon catheter dilatation.
CONCLUSION: Balloon catheter dilatation is generally effective in the treatment of congenital nasolacrimal duct obstruction as a primary procedure in children over 12 months of age, and as a procedure after failure of lacrimal system probing or silicone intubation.