Friday, April 13, 2012
Treating unilateral nasolacrimal duct obstruction in patients with Down syndrome
from Ocular Surgery News OSN Super Site:
Treatment of congenital nasolacrimal duct obstruction in patients with Down syndrome was effective, particularly in those with unilateral disease, a study showed.
Lacrimal drainage disorders are more common in children with Down syndrome than in other children.
"Careful punctal evaluation and management is advisable, and a possible delay of operative intervention in bilateral cases in patients 5 years and older aimed at improving hypotonia may be a wise decision," the study authors said. "Conversely, unilateral cases have to be treated early because unilateral disease and lower-end [nasolacrimal duct] obstruction are good prognostic factors."
Investigators retrospectively studied treatment records of 34 lacrimal drainage systems of 22 patients with Down syndrome who were a mean 47 months old. Three drainage systems were in patient 96 months or older, and eight drainage systems were in patients between 14 and 36 months old. Twelve patients had bilateral nasolacrimal duct obstruction. Mean follow-up was 20.3 months.
Study results showed that treatment was successful in 90% of unilateral cases and 45.8% of bilateral cases. The success rate of lower-end obstructions was 100%. The success rate of cases with multiple obstructions was 41.7%.
Treatment was successful in 91.7% of patients older than 64 months and 40.9% of patents younger than 64 months; the difference was statistically significant (P = .012), the authors said.
Congenital nasolacrimal duct obstruction (CLDO) is the condition in which a tear duct has failed to open at the time of birth. Around 6% of infants have CLDO, usually experiencing a persistent watery eye even when not crying. The condition is also known as dacryostenosis