Pressurized lacrimal duct irrigation for neonatal dacryocystitis: a pilot study of safety, effectiveness, and intervention timing

Objective The study aims to assess the effectiveness, safety, and age-related outcomes of a pressurized lacrimal duct irrigation technique in neonatal dacryocystitis. Methods The study analyzed the outcomes of 145 infants (166 eyes) diagnosed with neonatal dacryocystitis at Affiliated Xiamen Eye Center of Xiamen University. Participants were categorized into three age-based cohorts: Group A (3–5 months), Group B (6–8 months), and Group C (9–11 months). A modified pressurized lacrimal duct irrigation technique was performed to unblock the lacrimal duct. The lacrimal duct patency and incidence of related complications were observed and recorded after the procedure. The infants were followed up for a week, and the procedure was repeated if the blockage persisted. Results The overall patency rate was 83.73%, with rates of 94.83% in Group A, 84.48% in Group B, and 70.00% in Group C. Specifically, patency was achieved after the first intervention in 61 eyes (36.75%), after a second intervention in 51 eyes (30.72%), and after a third intervention in 27 eyes (16.27%). Complications such as lacrimal punctum tear, punctal ectropion, conjunctival hemorrhage, and corneal epithelial exfoliation were not observed, but four eyes presented with lacrimal duct mucosal hemorrhage and one eye had a pseudo-tract post-flushing. Conclusions The improved pressurized lacrimal duct irrigation technique for neonatal dacryocystitis was found to be safe and effective, with higher patency rates observed in infants aged 3–5 months.