Removal of a Silicone Cannula and Prognosis of Congenital Occlusion of theLacrimal Pathways

Overview

Objective:
Assessment of the prognostic value of the FDD test (fluorescein dyedisappearance test) for treatment of congenital occlusionof the lacrimal pathwaysby means of silicone intubation and for assessment of the time of removal of thecannula.Method: The drainage function of the lacrimal pathways was evaluated perspectivelyin a group of 46 children with inborn occlusin of the lacrimal pathways,aged 1-3 years, treated by means of silicone intubation. The evaluation was madebefore insertion of the cannula, one week, one month after the operation, duringremoval of the cannula, one month and one year after its removal. The results ofFDDT were compared with the clinical condition and the therapeutic results.Results: In all instances (36 children) where shortly after surgery regression ofthe signs and symptoms of occlusion occurred and FDDT was 0-1 the long-term result (one year after removal of the cannula) of treatment was favourable. Nineof 11 cases where FDDT 2-3 and signs of occlusion persisted also when the cannulawas removed after its removal marked improvement of the symptoms of occlusionoccurred or they disappeared and the drainage of the lacrimal pathways wasnormal.If FDDT suggests during the period with the inserted cannula a satisfactoryfunction of the lacrimal pathways, the prognosis of cure is good and the cannulacan be removed already after 6-8 weeks. If during the time with the cannula theimpaired drainage function of the lacrimal pathways persists, i.e. FDDT 2-3, it isbetter to remove the cannula not sooner than after 5-6 months.Conclusion: FDDT can serve as a prognostic factor in the treatment of congenitalocclusiom of the lacrimal pathways by means of a silicone cannula and forassessment of the time of its removal.

Key words:
congenitalocclusion - intubation -FDDT- intubationperiod -prognosis