Balloon dilatation for treatment of congenital nasolacrimal duct obstruction.

Objective: To evaluate the safety and effectiveness of balloon dacryocystoplasty in the treatment of congenital nasolacrimal duct obstructions.

Methods: Balloon dacryocystoplasty was attempted in 25 eyes of 21 patients. The procedure was performed successfully in 24 eyes of 20 patients, age range 21-72 months. Nineteen eyes had no previous procedure. The mean age of this group was 43.9 months (range 36-72 months). Five eyes had failed probing of lacrimal system. The mean age of this group was 22.2 months (range 21-24 months). The authors performed balloon dacryocystoplasty under endoscopic guidance. Clinical success was defined as complete remission of epiphora within follow-up period of 7-34 months (mean 25.2 months).

Results: The authors performed balloon dacryocystoplasty in 24 eyes. The first procedure was successful in 20 of them and the clinic success rate was 83.3%. The technique was repeated in the one eye that recurred and as it ended successfully, the clinic success rate increased to 87.5%. In 17 of the 19 eyes (89.4%) in which balloon dacryocystoplasty was performed primarily, and in 4 of 5 eyes (80%) in which balloon dacryocystoplasty was performed secondarily after unsuccessful probing, the procedure was clinically successful. There was intermittent epiphora in 3 eyes (15%) and these were considered as recurrence.

Conclusions: This experience shows that balloon dilatation is a safe and effective treatment of congenital nasolacrimal duct obstruction as a primary procedure in children over 36 months of age and as a secondary procedure after failure of lacrimal system probing. As a result, balloon dacryocystoplasty can be an alternative treatment in older children and can be preferred to silicone intubation and dacryocystorhinostomy performed after unsuccessful probing.