[Impact of age on success rate of lacrimal duct irrigation with silicone tube intubation in connatal lacrimal duct stenosis]. / Einfluss des Operationszeitpunktes auf den langfristigen Erfolg von Tränenwegsoperationen mit Schlauchintubation bei kindlicher Tränenwegsstenose.

ABSTRACT

BACKGROUND: Irrigation of the lacrimal duct with silicone tube intubation (TWS/S) remains the preferred treatment in persisting connatal lacrimal duct stenosis (kTWS). The timepoint of operation is however discussed controversely. On the one hand, it is recommended to wait for spontaneous opening of the lacrimal duct within the first year of life, on the other hand a later operation may trigger inflammatory changes within the lacrimal duct system influencing the success rate of the operation negatively. The aim of this study was to analyze the best time point of operation regarding the long-term success rate of the operation. PATIENTS/MATERIALS AND METHODS: 411 lacrimal ducts of 316 children with kTWS between 0 and 48 months of age (164 male, 156 female), who had undergone TWS with S because of kTWS at a tertiary eye care centre between 2007-2011 were included in this study. The children were divided into 6 groups of age (0-6, 7-12, 13-18, 19-24, 24-36, > 36 months) at the time of operation. The operative success was retrospectively evaluated after 36 months. The groups were compared and differences in late success rate analyzed statistically. RESULTS: The average success of operation of TWS/S in kTWS was 89 % (366 of 411 lacrimal ducts). The success rate of operation differed between the groups. If operated at the age of 0-6 months the operation was successful in 94 %, at the age 7-12 months in 91 %, between 13-18 months in 90.5 %, from 19-24 months in 88 %, and from 25-36 months in only 84.5 %. The success rate was therewith at the age of 25-36 months significantly lower than at the age of 0-6 months (p < 0.05). CONCLUSION: TWS/S in kTWS has overall a very high rate of success. The success of the operation decreases however in correlation with age at time of operation and shows with > 25 months significantly poorer results than at 0-6 months. The choice of the best time point for operation merits further investigation.