The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment) and imprecise results (few patients).
Probing is suggested for congenital lacrimal stenosis that does not resolve spontaneously
One trial was found from the Clinical Trials database of the Cochrane Library (search date 31.7.2009). An observational study and randomized trial 2 included 111 eyes of 95 patients in the second year of life. 26 eyes were included in a randomised prospective comparison of probing with spontaneous resolution. A further 63 eyes followed a similar management plan to the randomised group and were reported as an observational study. Thirty of the 50 eyes followed up without treatment resolved spontaneously before the age of 2 years, of which 24 resolved before 18 months. The overall cure rate for probing was 74% compared with 60% for spontaneous resolution. At 15 months of age in the RCT probing at 12-14 months was more effective compared with spontaneous resolution (p = 0.04).
A prospective study 1 enrolled 228 infants (300 nasolacrimal ducts). The first group was probed only; in the second group the nasolacrimal ducts were irrigated under high pressure using methylene blue-stained saline, and the third group was probed and irrigated in the same setting. Improvement was observed in 91 ducts after probing, 64 ducts after irrigation, and 96 ducts after both probing and irrigation.
Primary/Secondary Keywords