Probing in the treatment of congenital nasolacrimal duct obstruction: systematic review of randomized clinical trials

Abstract

The congenital nasolacrimal duct obstruction affects approximately 20% of neonates and usually stems from an imperforate Hasner valve. There is a great chance of spontaneous resolution, leading many professionals to adopt a conservative approach, based on the massage of the lacrimal sac, especially in the first year of life. However, there is no consensus about the best time to carry out the lacrimal probing, justifying this systematic review.The research project will be conducted in the Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Botucatu / UNESP - Botucatu-SP. A systematic review of the literature will be held, according to the methodology of the Cochrane Collaboration, aiming to map all clinical trials identified in major databases to assess the risk / benefit of the probing as monotherapy or adjuvant in the treatment of congenital nasolacrimal duct obstruction. The following databases will be searched: PubMed, CENTRAL (The Cochrane Library), EMBASE, Lilacs, and Clinical Trials. There will be considered randomized controlled trials or quasi-randomized to compare the early or late probing versus hydrostatic Crigler massage, empty out massage, dilation of the nasolacrimal duct, nasolacrimal intubation, canalicular intubation, conventional dacryocystorhinostomy, endoscopic dacryocystorhinostomy, combination of two or more interventions, or no intervention. Two reviewers will independently analyze, extract the data and select the potential studies.