Minimally Invasive Procedures for Tears Duct

If the symptoms of nasolacrimal duct obstruction do not improve with conservative treatment and proper follow-up, the ophthalmologist may recommend proceeding to interventional procedures to open the nasolacrimal duct and restore normal tear drainage.

Among the most common of these procedures are:

• Lacrimal probing or cannulation (Lacrimal Probing).

• Lacrimal intubation or placement of a lacrimal stent (Lacrimal Intubation).

First: Lacrimal probing or cannulation

Lacrimal probing is a common procedure for treating nasolacrimal duct obstruction in children, aiming to open the site of obstruction and allow tears to drain naturally into the nose.

Timing and evaluation are key to the success of these procedures, as the success of probing does not depend solely on the procedure itself, but is also influenced by the child's age, nature of the obstruction, duration of symptoms, and presence of previous interventions.

The age range of 9 to 18 months is a common period for performing probing in many cases, with the timing of intervention varying according to the child's age, severity of symptoms, nature of the obstruction, and presence of previous infections or interventions. However, there is no single suitable age for all children, and the timing of intervention is determined based on the evaluation of each case individually.

Second: When do we need to place a lacrimal stent?

Although probing is successful in most suitable cases, some children may require the placement of a lacrimal stent, which involves inserting a thin, flexible tube into the tear drainage system to help keep the duct open during the recovery period. A stent may be used in cases where the obstruction is more complex, or when the obstruction persists or recurs after probing.

There are different types of stents used in children, and the appropriate type is chosen based on the child's age, nature of the obstruction, and clinical condition.

In summary

Probing and stenting are not a single procedure, and they are not used in the same way for all children. Probing alone may be sufficient in some cases, while stenting may be a useful addition in other cases.