Endoluminal lacrimal duct recanalization for pediatric secondary acquired lacrimal duct obstruction following epidemic keratoconjunctivitis.

Abstract

Purpose: This study aimed to evaluate the efficacy of endoluminal lacrimal duct recanalization (ELDR) with intubation using dacryoendoscopy for secondary acquired lacrimal duct obstruction (SALDO) following epidemic keratoconjunctivitis (EKC) in children.

Study design: Prospective observational study.

Methods: We included 27 pediatric patients with EKC-derived SALDO between 2013 and 2023. All patients underwent ELDR with intubation for lacrimal pathway obstruction after EKC.

Results: We included 14 boys and 13 girls with unilateral obstructions (20 right and 7 left). The mean age at EKC onset and treatment was 23.4 ± 24.1 and 58.9 ± 42.4 months, respectively, and the mean interval from onset to treatment was 35.9 ± 29.0 months. Nineteen cases had a single blockage (common canalicular obstruction [CCO], sac-duct junction [SDJ], punctal obstruction, and canalicular obstruction in 7, 10, 1, and 1 case, respectively); five had two blockages (CCO and SDJ in 4 cases and SDJ and the lower end of the duct in 1 case), and three had diffuse blockages (2 with diffuse proximal nasolacrimal duct obstruction [NLDO] and 1 with CCO and diffuse proximal NLDO). All patients had tube stents, with a mean intubation period of 64.0 ± 26.3 days. Outcomes were classified as good, fair, and poor in 25 patients, 2 patients, and none, respectively.

Conclusion: CCO and SDJ were the primary lacrimal pathway obstruction sites following EKC in children. ELDR combined with intubation using dacryoendoscopy demonstrated favorable outcomes, supporting its role as an effective treatment option for secondary EKC-derived SALDO in children.