Tobramycin/dexamethasone eye drops as a better choice for lacrimal duct probing in persistent congenital nasolacrimal duct obstruction: A consort study

BACKGROUND: Congenital nasolacrimal duct obstruction (CNLDO) is common and. lacrimal duct probing is the major treatment. But persistent CNLDO in older children makes the success rate rapidly decreased due to long-term chronic inflammation. To improve the success rate, probing combined with tobramycin/dexamethasone ointment is considered effective. But in practice, we found a lot of problems in using the ointment. So we tried tobramycin/dexamethasone eye drops as a replacement. The results is surprising, so we hope to do some further research in order to prove it is worth to clinical application. OBJECTIVE: To evaluate the effect of lacrimal duct probing combined with tobramycin/dexamethasone eye drops or ointment on persistent CNLDO in children older than 1-year-old. METHODS: This randomized controlled study included 409 subjects (496 eyes) older than 1-year-old with persistent CNLDO in southwest China, and classified into 3 groups: 96 cases (123 eyes) were the tobramycin/dexamethasone eye drops group (drops group), 88 cases (104 eyes) were the tobramycin/dexamethasone ointment group (ointment group), and 225 cases (269 eyes) were control group which probing with normal saline (NS group). The data of age, sex, and laterality were analyzed through pairwise comparison. Then the 3 groups were divided into 2 subgroups by age, 12 to 24 months and 25 to 36 months. The surgical findings and success rate in two subgroups were compared. RESULTS: The success rates in the tobramycin/dexamethasone eye drops group in both 2 age subgroups were significantly higher than that in the ointment group and NS group (P < .05). CONCLUSIONS: Probing combined with tobramycin/dexamethasone eye drops was effective and easy-to-perform in the clinic, and it may be a better choice for persistent CNLDO.