Endoscopic and surgical evaluation of epiphora in children with Down syndrome

IF 1.3 4区医学 Q3 OPHTHALMOLOGY

Journal of Aapos Pub Date : 2025-12-01 Epub Date: 2025-11-19 DOI:10.1016/j.jaapos.2025.104687

Jutaro Nakamura MD, PhD , Mizuki Asano MD , Tomoko Ohno MD, PhD , Satoshi Goto MD, PhD , Nobuhisa Mizuki MD, PhD , Nozomi Matsumura MD, PhD

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引用次数: 0

Abstract

Purpose

To examine the clinical characteristics and surgical outcomes of patients with Down syndrome (DS) presenting with primary epiphora.

Methods

The medical records of children with DS referred to a tertiary academic children’s hospital between 2013 and 2023 were reviewed, and 63 patients with primary epiphora were included in our analysis. Clinical characteristics, diagnostic findings, and surgical intervention outcomes were analyzed.

Results

Forty-two patients (67%) had epiphora since birth, and 12 patients (19%) developed symptoms after the first year of life. Of the 40 patients who underwent lacrimal syringing, 28 (70%) showed passage, and 12 showed obstruction. Surgical intervention was performed in 18 patients. Either office-based probing under local anesthesia or endoluminal lacrimal duct recanalization (ELDR) with stent intubation under general anesthesia was performed. In the 18 patients who underwent surgery, surgical outcomes were as follows: complete resolution of symptoms in 7 patients, partial resolution in 10 patients, and failure in 1 patient. Dacryoendoscopy revealed dense white fibrous tissue obstructing the mucosal surface of the nasolacrimal duct in several cases, indicating chronic inflammatory changes.

Conclusions

Dacryoendoscopic findings revealed not only stenotic lacrimal passages due to developmental anomalies of the lacrimal drainage system but also fibrous obstruction secondary to chronic inflammation. Surgical intervention limited to probing or ELDR resulted in only partial symptom improvement in two-thirds of patients, without achieving complete resolution.

查看原文本刊更多论文

唐氏综合征患儿上睑下垂的内镜和手术评价。

目的：探讨唐氏综合征（DS）原发性上睑下垂患者的临床特点和手术效果。方法：回顾性分析某三级专科儿童医院2013 - 2023年就诊的DS患儿病历，其中63例为原发性上显。分析临床特征、诊断结果和手术干预结果。结果：42例（67%）患者出生后出现显色，12例（19%）患者出生后出现显色。40例接受泪道冲洗的患者中，28例（70%）出现通道，12例出现阻塞。手术干预18例。局部麻醉下的办公室探查或全麻下的腔内泪管再通术（ELDR）与支架插管。在接受手术的18例患者中，手术结果如下：7例患者症状完全缓解，10例患者部分缓解，1例患者失败。泪内窥镜检查显示，数例鼻泪管粘膜表面有致密的白色纤维组织阻塞，提示慢性炎症改变。结论：泪道内窥镜检查结果显示，泪道狭窄不仅是由于泪道引流系统发育异常引起的，而且还包括继发于慢性炎症的纤维性阻塞。限于探查或ELDR的手术干预仅导致三分之二患者的部分症状改善，而没有达到完全解决。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Aapos 医学-小儿科

CiteScore

2.40

自引率

12.50%

发文量

159

审稿时长

55 days

期刊介绍： Journal of AAPOS presents expert information on children''s eye diseases and on strabismus as it affects all age groups. Major articles by leading experts in the field cover clinical and investigative studies, treatments, case reports, surgical techniques, descriptions of instrumentation, current concept reviews, and new diagnostic techniques. The Journal is the official publication of the American Association for Pediatric Ophthalmology and Strabismus.