The effectiveness of the Ritleng lacrimal intubation system and lacrimal passage in children with acquired nasolacrimal duct obstruction

Objective To evaluate the effectiveness of the reconstruction of the lacrimal passage combined with the Ritleng intubation system in the treatment of childen's obstruction of the lacrimal duct secondary to conjunctivitis. Methods In this retrospective cases-series study, 43 children (49 eyes) who ranged in age from 8 months to 11 years old participated. All children underwent reconstruction of the lacrimal passage combined with the Ritleng intubation system under general anesthesia. The follow-up period was from 6 to 12 months after surgery. The tubes were left in place between 2 and 6 months depending on the situation. After extubation, clinical success was defined as lacrimal patency, but sometimes there was some lacrimal resistance along with tear drainage. The surgery was considered ineffective if the tear duct was not penetrated. Results Based on the obstruction site, all the children were divided into 4 types: lacrimal canalicular obstruction (9 cases) , lacrimal duct obstruction (12 eyes) , obstruction of the nasolacrimal duct (4 eyes) , and complex duct obstruction (24 eyes). After extubation, the overall success rate was 65% (32/49) and the melioration rate was 20% (10/49). On the other hand, the procedure was ineffective in 7 eyes (14%). Conclusion The reconstruction of the lacrimal passage combined with the Ritleng intubation system is a safe and effective procedure for the treatment of secondary nasolacarimal duct obstruction. Key words: Acquired nasolacarimal duct obstruction; Child; Lacrimal reconstruction; Lacrimal intubation