CLINICAL PREDICTORS OF PRIMARY NASOLACRIMAL DUCT PROBING FAILURE IN CHILDREN WITH CONGENITAL NASOLACRIMAL DUCT OBSTRUCTION

Abstract

Purpose. To identify clinical and anamnestic factors associated with failure of primary nasolacrimal duct probing in children with congenital nasolacrimal duct obstruction (CNLDO). Materials and Methods. A retrospective study was conducted involving 48 children with CNLDO who underwent primary nasolacrimal duct probing between 20XX and 20XX. Clinical variables analyzed included age at surgery, disease laterality, history of dacryocystitis, and duration of symptoms prior to intervention. Treatment success was defined as complete resolution of epiphora and mucopurulent discharge without the need for additional surgical procedures during follow-up. Patients were divided into successful and failed probing groups. Statistical analysis was performed using Student’s t-test, chi-square test, and Fisher’s exact test. A p-value <0.05 was considered statistically significant. Results. The overall success rate of primary probing was 83,3% (40/48), while treatment failure requiring additional intervention occurred in 16,7% (8/48) of patients. Children with unsuccessful outcomes were significantly older than those with successful outcomes (17,4±5,1 / 10,7±4,8 months, p=0,002). Age greater than 12 months was significantly associated with probing failure (75,0% / 27,5%, p=0,011). Bilateral disease (50,0% / 12,5%, p=0,018), a history of dacryocystitis (62,5% / 25,0%, p=0,042), and symptom duration exceeding six months (87,5% / 35,0%, p=0,008) were also significantly more frequent among patients with failed primary probing. Conclusion. Primary nasolacrimal duct probing is a highly effective treatment for CNLDO. However, older age at intervention, bilateral involvement, previous dacryocystitis, and prolonged symptom duration are associated with an increased risk of treatment failure. Recognition of these factors may improve preoperative risk stratification and facilitate individualized treatment planning in children with CNLDO.