Evaluation of adjunctive methylcellulose in congenital nasolacrimal duct obstruction probing

Purpose Congenital nasolacrimal duct obstruction (CNLDO) is a commonly encountered problem in ophthalmic practice causing excessive tearing and/or mucopurulent discharge in infants. The purpose of this study is to report the success rate of probing in adjunction with methylcellulose in infants with congenital nasolacrimal duct obstruction. Methylcellulose increases of the success rate of probing, enhances the drainage of the tears and widening the nasolacrimal system. Such technique can improve the probing procedure, decreases the incidence of recurrence and eliminates the need for second redilatation (reprobing). Patients and methods A total of 90 eyes of 83 patients were recruited in the current study. The mean±SD of age was 12±3.7 (7–21) months. Fifty-one (61.4%) of patients were females while 32 (38.6%) were male. Patients were divided into two main groups, group I: 45 eyes of 40 patients (case), and group II (control): 45 eyes of 43 patients. The procedure has been performed under general anesthesia in all cases, with insertion of a nasal pack with adrenaline 1:200 000 in the inferior meatus. Conventional probing was done to group II (control), while the methylcellulose injection using Shahinian cannula before probing dilatation was done to group I (cases). Results Three successive follow-up assessments were done as regard epiphora, edema, and discharge. Group I demonstrated significantly better results than group II, P <0.0001, P <0.0001, and P =0.035 at 1 day, 1 week, and 4 weeks assessments, respectively. The success rate was defined by the resolution of tearing and/or discharge. The success rate was 97.8% (44 cases) in group I and 77.8% (35 cases) in group II. Failure was defined by the need for a second probing. Conclusion Using methylcellulose before conventional probing in CNLDO enhances the success rate of treatment and decreases the incidence of second intervention.