A Report by the American Academy of Ophthalmology Ophthalmic Technology Assessment Committee Oculoplastics and Orbit Panel: Edward J. Wladis, MD,1 Vinay K. Aakalu, MD, MPH,2 Michael T. Yen,3 MD, Jurij R. Bilyk, MD,4 Rachel K. Sobel, MD,5 Louise A. Mawn, MD6
Ophthalmology, April 2018, Vol 125, 1654-1657 © 2018 by the American Academy of Ophthalmology. Click here for free access to the OTA.
Purpose: To identify the efficacy and adverse event rates of balloon dacryoplasty in cases of congenital nasolacrimal duct obstruction in children who fail to respond to an initial nasolacrimal duct probing.
Methods: A literature search was last performed in September 2017 in the PubMed database to identify all reports of balloon dacryoplasty. All searches up to and including the last search were limited to the English language, and they yielded 104 articles that were assessed for relevancy. Thirty-six articles were selected for full review, and 8 of these were selected for inclusion in this assessment and assigned a quality of evidence rating by the panel methodologist.
Results: Three of the 8 studies included in this assessment were rated level II, and 5 were rated level III. Success rates varied from 75% to 100%. Only 2 complications were identified, and these were cases of self-limited postoperative emesis. The 2 studies that compared balloon dacryoplasty with lacrimal stenting reported that outcomes were comparable between the 2 techniques.
Conclusions: Although level I evidence was not available, the studies that were uncovered in the literature review indicate that balloon dacryoplasty is a safe, effective procedure to address congenital nasolacrimal duct obstruction that persists after standard probings. The outcomes of this intervention are similar to those of lacrimal stenting, and the absence of an implanted stent theoretically reduces the risk of complications.
1 Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical Center, Albany (Slingerlands), New York.
2 Illinois Eye and Ear Infirmary, University of Illinois College of Medicine at Chicago, Chicago, Illinois
3 Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
4 Wills Eye Hospital, Philadelphia, Pennsylvania.
5 Vanderbilt Eye Institute, Vanderbilt University, Nashville, Tennessee.
6 Vanderbilt Eye Institute, Vanderbilt University, Nashville, Tennessee.