Resolution of Congenital Nasolacrimal Duct Obstruction With Nonsurgical Management
Resolution of Congenital Nasolacrimal Duct Obstruction With Nonsurgical Management
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DOI：
10.1001/archophthalmol.2012.454
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发表时间：
2012-06-01
影响因子：
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通讯作者：
Vaswani, Reena S.
中科院分区：
文献类型：
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作者：
Petersen, David B.;Chandler, Danielle L.;Vaswani, Reena S.
目的：确定6至10个月以下婴儿的鼻泪管梗阻（NLDO）在6个月的非手术治疗后消退的频率。方法：作为一项随机试验的一部分，评估即时办公室探查与延迟探查对未解决病例的观察的成本效益，107名6至10个月以下的婴儿，他们患有NLDO，没有鼻泪管手术史，给予6个月的鼻泪管按摩和局部抗生素治疗。NLDO的消退在研究开始6个月后进行评估，并被定义为没有NLDO的所有临床症状（上溢、泪湖增加或粘液分泌物）和未接受NLDO手术。探索性分析评估了基线特征（包括年龄、性别、侧边和既往治疗）是否与NLDO不手术解决的可能性相关。结果：在6个月的检查中，133只眼睛中的117只（88%）完成了检查，77只眼睛的NLDO没有手术解决（66% [95% CI, 56%-74%]）。我们评估的基线特征均未发现与分辨率相关。结论：在6至10个月以下的婴儿中，超过一半的NLDO会在6个月内通过非手术治疗解决。了解婴儿期NLDO不经手术解决的比率将有助于临床医生和家长有效地讨论治疗方案。
Objective: To determine how often nasolacrimal duct obstruction (NLDO) resolves with 6 months of nonsurgical management in infants aged 6 to less than 10 months.Methods: As part of a randomized trial evaluating the cost-effectiveness of immediate office probing vs observation with deferred probing for unresolved cases, 107 infants aged 6 to less than 10 months who had NLDO and no history of nasolacrimal duct surgery were prescribed 6 months of nasolacrimal duct massage and topical antibiotics as needed. Resolution of the NLDO was assessed 6 months after study entry and was defined as the absence of all clinical signs of NLDO (epiphora, increased tear lake, or mucous discharge) and not having undergone NLDO surgery. Exploratory analyses assessed whether baseline characteristics, including age, sex, laterality, and prior treatment, were associated with the probability of NLDO resolving without surgery.Results: At the 6-month examination, which was completed for 117 of the 133 eyes (88%), the NLDO had resolved without surgery in 77 eyes (66% [95% CI, 56%-74%]). None of the baseline characteristics we evaluated were found to be associated with resolution.Conclusions: In infants 6 to less than 10 months of age, more than half of eyes with NLDO will resolve within 6 months with nonsurgical management. Knowledge of the rate of NLDO resolution in infancy without surgery will help clinicians and parents effectively discuss treatment options.