Efficacy of patient-self sac compression on conservative treatment of nasolacrimal duct obstruction.
Keywords:
Keywords: Nasolacrimal duct obstruction, Nasolacrimal sac compression, Conservative managementAbstract
Efficacy of patient-self sac compression on conservative treatment of nasolacrimal duct obstruction
Petchrada Ung-aram MD.
Purpose: To evaluate the efficacy of patient-self sac compression for improving clinical symptoms and quality of life in primary nasolacrimal duct obstruction.
Methods: This study included 24 eyes in 20 patients diagnosed with distal nasolacrimal duct obstruction. Twice daily patient-self sac compression was advised to be the conservative treatment or performed with eyelid hygiene care before lacrimal surgery. Tear meniscus height (TMH) measurements and quality of life questionnaires were performed and the results were compared pre and post treatment.
Results: Out of 20 patients, 19 were women. The mean age at surgery was 70.4+9.83 years. Out of 24 eyes, 10 (40.7%) had a history of prior infection, and14 eyes (58.3%) were simple epiphora without infection. The pre- treatment values of the TMH, health utility values and EQ-5D VAS scores were 0.41+ 0.12 mm, 0.84+0.16 and 80.5+14.68, respectively. The post treatment TMH decreased significantly compared to the pre- treatment values. The health utility values increased significantly only in patients with a history of prior infection. The EQ-5D VAS scores difference was not statistically significant in all patients. Only 1 of 20 patients had one attack of acute on-top chronic dacryocystitis with a mean follow up of 14.2 months. Ten of 20 patients could have avoided surgery in this study.
Conclusion: These results suggest that patient-self sac compression might be effective in the conservative management of NLDO.
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