Lacrimal intubation with the Ritleng system in congenital nasolacrimal duct obstruction in children

Abstract

To evaluate the efficacy and complication of the Ritleng lacrimal intubation system in the treatment of congenital nasolacrimal duct obstruction. In this retrospective cases series, 148 patients (187 eyes) with congenital nasolacrimal duct obstruction between 2006 and 2007 from Beijing Children's Hospital, whose age ranged from 5 to 40 months (average 13 months), underwent silicone intubation with the Ritleng lacrimal intubation system, who received unsuccessful probing procedure previously. The therapeutic effect including dacryorrhea disappearance and lacrimal passages excretory function regaining was observed and the complications such as epistaxis, lacrimal duct edema or silicone tube prolapse were recorded. The follow-up period was from 4 to 17 months (average 11 months). Dacryorrhea disappeared in 157 eyes (84.0%) within 1 - 3 days after the surgery. The tubes were left in the place for 3 or 6 months. All the 187 eyes were successfully taken out of tubes. As follow-up, the overall successful rate was 95.2% (178/187). Seven eyes (3.7%) relief from symptoms and two eyes (1.1%) were ineffective. 46 cases (52 eyes), whose ages were about 5 months, regained normal lacrimal passages excretory function within 1 month after surgery. Complication included epistaxis (9 eyes) and lacrimal duct edema (9 eyes). The silicone tube prolapsed in eight eyes (4.3%). The Ritleng lacrimal intubation system is an easy, effective and nontraumatizing procedure for the treatment of congenital nasolacrimal duct obstruction. The lacrimal intubation procedure offers an early and active treatment for congenital nasolacrimal duct obstruct patients.