Assessing the success rate of treatment in simple and complex congenital nasolacrimal duct obstruction: a systematic review and meta-analysis.

Autor: Eshraghi B; Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran., Babaei L; Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran., Moradi M; Eye Research Center, Eye Department, School of Medicine, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran., Chaibakhsh S; Eye Research Center, Eye Department, School of Medicine, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran. smr.chaibakhsh@gmail.com., Aghajani A; Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran. aliaghajani_y@yahoo.com.; Eye Research Center, Eye Department, School of Medicine, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran. aliaghajani_y@yahoo.com.
Jazyk: angličtina
Zdroj: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2024 Jul; Vol. 262 (7), pp. 1993-2004. Date of Electronic Publication: 2023 Dec 07.
DOI: 10.1007/s00417-023-06318-4
Abstrakt: Purpose: 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.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: