Assessing the success rate of treatment in simple and complex congenital nasolacrimal duct obstruction: a systematic review and meta‑analysis
Ali Aghajani1 *
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract: To assess and compare the success rate (SR) of probing and intubation in patients with congenital nasolacrimal
duct obstruction (CNLDO).
Methods: We conducted a literature search for identifying relevant studies published in English using PubMed, Google Scholar, Scopus, and Web of Science databases from the date of inception to Feb 2023. After extracting data, the SR was compared between the study groups: simple and complex CNLDO. To compare the treatment outcome, the mean difference of the SR was considered as the effect size. Random effects model or fixed effects model were performed for statistical inferences.
Results: A total of 21 studies were eligible to be analyzed. The pooled SR of treatment was 88% in simple, and 57% in
complex CNLDO. Exerting intubation in increased the SR from 87% (SR of probing) to 92% in simple CNLDO which was
not significant. However, compared to probing, intubation has a significantly higher SR in complex CNLDO (46 to 82%).
While the SR of probing was significantly lower in complex CNLDO, the difference between the SR of intubation was not
significant between groups. Although increasing the age does not have an adverse effect on the SR in simple CNDLO, it
causes a significant decrease in the SR of complex group.
Conclusion: This study revealed that even though the addition of NLD intubation does not provide significant benefits beyond
probing alone for patients with simple CNLDO, in children with complex CNLDO, NLD intubation should be considered
as a primary treatment due to its substantial increase in surgical success rates. Delaying the treatment would increase its
success in patients with complex but not the simple CNLDO.
