Balloon catheter dilation for complex congenital nasolacrimal duct obstruction in older children.

Objective: To evaluate the effectiveness of lacrimal balloon catheter dilation in the treatment of complex congenital nasolacrimal duct obstruction in older children.

Methods: In a retrospective study, the case records of 65 eyes of 59 children 2 to 6 years (mean: 37 months) who underwent probing for congenital nasolacrimal duct obstruction were evaluated. Complex obstruction was noted in 21 (32.3%) of the 65 children older than 2 years who underwent probing. Secondary balloon dacryoplasty was performed in 8 (38.09%) of these 21 lacrimal systems. Patient age ranged from 3 to 6 years (mean: 47 months). Balloon catheter dilation was performed according to a standard protocol. Clinical patency of the nasolacrimal system was the main outcome measure and was defined as complete resolution of signs and symptoms (crusting, discharge, and watering) on follow-up. The procedures were performed under general anesthesia. All dilations were performed by the same lacrimal surgeon.

Results: Secondary balloon dacryoplasty was successful in seven of the eight lacrimal systems (87.5%). Complex obstruction at the distal end of the nasolacrimal duct was noted in all children. All children were older than 3 years (mean: 37 months), and all underwent secondary procedures because previous probing was unsuccessful.

Conclusions: Balloon catheter dilation is an effective procedure for complex nasolacrimal duct obstruction in older children. It can be an alternative to silicone intubation and dacryocystorhinostomy in children after unsuccessful probing.