Endoscopic-guided monocanalicular versus bicanalicular Ritleng intubation for treating congenital nasolacrimal duct obstruction in patients aged 24-53 months.

Abstract

Background: Congenital nasolacrimal duct obstruction (CNLDO) is a common condition in neonates, often requiring intervention when conservative treatments and simple probing fail. This study aimed to explore the efficiency and safety of endoscopic-guided bicanalicular (BC) and monocanalicular (MC) Ritleng intubation in treating CNLDO.

Methodology: This multicenter, prospective, nonrandomized comparative study was conducted between 2007 and 2022. The study included a total of 90 patients aged 24-53 months who had either failed probing or presented late with CNLDO. The participants were divided into two groups: 45 treated with BC and the other 45 with MC Ritleng intubation. Surgical procedures were performed under general anesthesia. Follow-up visits were scheduled at 1 week postoperatively, then at 1 month, and 3 months after stent removal. Finally, postoperative outcomes were analyzed.

Results: The clinical success rates were comparable, with BC achieving 93.3% and MC achieving 92.2% (P = 0.68). BC intubation was associated with a higher complication rate (28.9%) compared to MC (4.4%), with a statistically significant difference (P = 0.004). The study also revealed the absence of significant associations between the incidence of complications and age, gender, or preexisting conditions (P = 0.90).

Conclusions: Both BC and MC Ritleng intubation are effective treatments for late-presenting CNLDO and cases following failed probing. However, MC intubation stands out as a safer and quicker option, significantly reducing the risk of complications. This study emphasizes the advantages of MC Ritleng intubation for pediatric patients with CNLDO.