Clinical Study
Eye (2008) 22, 918–924; doi:10.1038/sj.eye.6702769; published online 16 March 2007
Lacrimal drainage obstruction and dacryocystorhinostomy in children
The authors have no financial interest in any of the materials used in this study
The addresses of the institutions at which the work was carried out: Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital, Macquarie Street, Sydney, NSW 2000, Australia
A Y Nemet1, A Fung1, P A Martin1, R Benger1, G Kourt1, J J Danks1 and J C Tong1
1Oculoplastic unit, Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital, Sydney, New South Wales, Australia
Correspondence: AY Nemet, Department of Ophthalmology, Sydney Eye Hospital, Macquarie Street, GPO Box 1614, Sydney, NSW, 2000, Australia. Tel: +612 93691608; Fax: +612 9387 1259; E-mail: nemeta@yahoo.com
Received 26 May 2006; Revised 22 January 2007; Accepted 22 January 2007; Published online 16 March 2007.
Abstract
Purpose
To determine the outcome of dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction (NLDO) in children.
Methods
A review of medical records of 104 cases (82 patients) of paediatric DCR who underwent DCR at the Sydney Eye Hospital from 1995 to 2004. The main outcome measures included post-operative symptomatic relief of presenting symptoms, complications, subjective visibility of any scar, and general satisfaction. Statistical methods included 
2 tests, and Student's t-tests for the comparison of variables among groups.
Results
Ninety-four external, 10 endoscopic primary procedures, and five revision procedures were included. Fifty-six of the cases were primary NLDO, and 48 were secondary NLDO. The mean follow-up was 1.44 years. Average age at surgery was 6.6
4.2 years (meanSD). Ninety-one eyes needed DCR for the involvement of the lower lacrimal outflow system, and 13 eyes were NLDO associated with congenital punctual/canalicular dysgenesis.
Most of the complications of external DCR were related to Jones tube placement. Five cases (4.8%) needed DCR revision. There was a significantly higher incidence of revision surgery in the non-stented group (P<0.01), and the Jones tube group (P<0.001) as compared with the silicone intubation stent group.
Conclusions
External DCRs have acceptable long-term clinical and cosmetic results, and low post-operative complication rate. Cases with punctal stenosis or those requiring Jones tube insertion are associated with a higher complication rate. Silicone intubation is associated with a lower need for operative revision.
Keywords:
dacryocystorhinostomy, paediatric nasolacrimal obstruction, silicone stenting, jones tube
