Factors Associated With Nasolacrimal Duct Probing Failure Among Children in the Intelligent Research in Sight Registry
IMPORTANCE: Understanding the factors associated with nasolacrimal duct probing failure in young children may help inform practice patterns. OBJECTIVE: To identify factors associated with repeated nasolacrimal duct probing in young children. DESIGN, SETTING, AND PARTICIPANTS: This retrospective coho...
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| Veröffentlicht in: | Archives of ophthalmology (1960) 2023-04, Vol.141 (4), p.342-348 |
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| creator | Oke, Isdin Elze, Tobias Miller, Joan W Lorch, Alice C Hunter, David G Elliott, Alexandra T |
| description | IMPORTANCE: Understanding the factors associated with nasolacrimal duct probing failure in young children may help inform practice patterns. OBJECTIVE: To identify factors associated with repeated nasolacrimal duct probing in young children. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study analyzed data from the Intelligent Research in Sight (IRIS) Registry for all children who underwent nasolacrimal duct probing before 4 years of age between January 1, 2013, and December 31, 2020. MAIN OUTCOMES AND MEASURES: The Kaplan-Meier estimator was used to assess the cumulative incidence of a repeated procedure within 2 years of the initial procedure. Hazard ratios (HRs) derived from multivariable Cox proportional hazards regression models were used to evaluate the association between repeated probing and patient age, sex, race and ethnicity, geographic region, operative side, laterality of obstruction, type of initial procedure, and surgeon volume. RESULTS: This study included 19 357 children (9823 [50.7%] male; mean [SD] age, 1.40 [0.74] years) undergoing nasolacrimal duct probing. The cumulative incidence of repeated nasolacrimal duct probing was 7.2% (95% CI, 6.8%-7.5%) within 2 years of the initial procedure. Among 1333 repeated procedures, the second procedure involved silicone intubation in 669 (50.2%) and balloon catheter dilation in 256 (19.2%). Among 12 008 children aged 1 year or younger, office-based simple probing was associated with a slightly higher probability of reoperation compared with facility-based simple probing (9.5% [95% CI, 8.2%-10.8%] vs 7.1% [95% CI, 6.5%-7.7%]; P |
| doi_str_mv | 10.1001/jamaophthalmol.2023.0004 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2781622051</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>2802117</ama_id><sourcerecordid>2781622051</sourcerecordid><originalsourceid>FETCH-LOGICAL-a412t-dfa0ecad7c29c80d8dc602ccdb6ccd8f331fef43c9937648248b02e33397a5353</originalsourceid><addsrcrecordid>eNpdkdtKwzAYgIMoTtQX8EIC3nizmUObppdjOhVExQNehixN14y0mUkq-PambA70Jqf_-w_kAwBiNMEI4auVbKVbN7GRtnV2QhChE4RQtgeOCGZ8zHBB93dnlo_AaQirRCCeKJofghFlnBHK2RH4mksVnQ9wGoJTRkZdwQ8TG_gog7NSedNKC697FeGzdwvTLeFcGtt7DaetS7dZY2zldQdNB2Oj4X0XtbVmqbsIX3TQ0qtmiL2aZTO8LE2I_vsEHNTSBn263Y_B-_zmbXY3fni6vZ9NH8YywySOq1oirWRVKFIqjipeKYaIUtWCpYXXlOJa1xlVZUkLlnGS8QUimlJaFjKnOT0Gl5u6a-8-ex2iaE1QaUDZadcHQQqOGSEoxwm9-IeuXO-7NJ0gHLE8Z5yWieIbSnkXgte1WA9f5L8FRmLQI_7qEYMeMehJqefbBv2i1dUu8VdGAs42QKqwi6beBCejP7IimPw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2806556839</pqid></control><display><type>article</type><title>Factors Associated With Nasolacrimal Duct Probing Failure Among Children in the Intelligent Research in Sight Registry</title><source>MEDLINE</source><source>American Medical Association Journals</source><source>Alma/SFX Local Collection</source><creator>Oke, Isdin ; Elze, Tobias ; Miller, Joan W ; Lorch, Alice C ; Hunter, David G ; Elliott, Alexandra T</creator><creatorcontrib>Oke, Isdin ; Elze, Tobias ; Miller, Joan W ; Lorch, Alice C ; Hunter, David G ; Elliott, Alexandra T ; IRIS Registry Analytic Center Consortium</creatorcontrib><description>IMPORTANCE: Understanding the factors associated with nasolacrimal duct probing failure in young children may help inform practice patterns. OBJECTIVE: To identify factors associated with repeated nasolacrimal duct probing in young children. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study analyzed data from the Intelligent Research in Sight (IRIS) Registry for all children who underwent nasolacrimal duct probing before 4 years of age between January 1, 2013, and December 31, 2020. MAIN OUTCOMES AND MEASURES: The Kaplan-Meier estimator was used to assess the cumulative incidence of a repeated procedure within 2 years of the initial procedure. Hazard ratios (HRs) derived from multivariable Cox proportional hazards regression models were used to evaluate the association between repeated probing and patient age, sex, race and ethnicity, geographic region, operative side, laterality of obstruction, type of initial procedure, and surgeon volume. RESULTS: This study included 19 357 children (9823 [50.7%] male; mean [SD] age, 1.40 [0.74] years) undergoing nasolacrimal duct probing. The cumulative incidence of repeated nasolacrimal duct probing was 7.2% (95% CI, 6.8%-7.5%) within 2 years of the initial procedure. Among 1333 repeated procedures, the second procedure involved silicone intubation in 669 (50.2%) and balloon catheter dilation in 256 (19.2%). Among 12 008 children aged 1 year or younger, office-based simple probing was associated with a slightly higher probability of reoperation compared with facility-based simple probing (9.5% [95% CI, 8.2%-10.8%] vs 7.1% [95% CI, 6.5%-7.7%]; P < .001). In the multivariable model, a greater risk of repeated probing was associated with bilateral obstruction (HR, 1.48; 95% CI, 1.32-1.65; P < .001) and office-based simple probing (HR, 1.33; 95% CI, 1.13-1.55; P < .001), and a lower risk was associated with primary balloon catheter dilation (HR, 0.69; 95% CI, 0.56-0.85; P < .001) and procedures performed by high-volume surgeons (HR, 0.84; 95% CI, 0.73-0.97; P = .02). Age, sex, race and ethnicity, geographic region, and operative side were not associated with reoperation risk in the multivariable model. CONCLUSIONS AND RELEVANCE: In this cohort study, most children in the IRIS Registry undergoing nasolacrimal duct probing before 4 years of age did not require any additional intervention. Factors associated with lower risk of reoperation include surgeon experience, probing performed under anesthesia, and primary balloon catheter dilation.</description><identifier>ISSN: 2168-6165</identifier><identifier>EISSN: 2168-6173</identifier><identifier>DOI: 10.1001/jamaophthalmol.2023.0004</identifier><identifier>PMID: 36862386</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Age ; Anesthesia ; Balloon catheters ; Balloon treatment ; Catheters ; Child ; Child, Preschool ; Children ; Cohort analysis ; Cohort Studies ; Dacryocystorhinostomy ; Ethnicity ; Female ; Humans ; Infant ; Intubation ; Lacrimal Duct Obstruction - diagnosis ; Lacrimal Duct Obstruction - therapy ; Lacrimal gland and Nasolacrimal duct ; Male ; Minority & ethnic groups ; Nasolacrimal Duct - surgery ; Regression analysis ; Retrospective Studies ; Silicones ; Treatment Outcome</subject><ispartof>Archives of ophthalmology (1960), 2023-04, Vol.141 (4), p.342-348</ispartof><rights>Copyright American Medical Association Apr 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a412t-dfa0ecad7c29c80d8dc602ccdb6ccd8f331fef43c9937648248b02e33397a5353</citedby><cites>FETCH-LOGICAL-a412t-dfa0ecad7c29c80d8dc602ccdb6ccd8f331fef43c9937648248b02e33397a5353</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamaophthalmology/articlepdf/10.1001/jamaophthalmol.2023.0004$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2023.0004$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,776,780,3327,27901,27902,76458,76461</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36862386$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oke, Isdin</creatorcontrib><creatorcontrib>Elze, Tobias</creatorcontrib><creatorcontrib>Miller, Joan W</creatorcontrib><creatorcontrib>Lorch, Alice C</creatorcontrib><creatorcontrib>Hunter, David G</creatorcontrib><creatorcontrib>Elliott, Alexandra T</creatorcontrib><creatorcontrib>IRIS Registry Analytic Center Consortium</creatorcontrib><title>Factors Associated With Nasolacrimal Duct Probing Failure Among Children in the Intelligent Research in Sight Registry</title><title>Archives of ophthalmology (1960)</title><addtitle>JAMA Ophthalmol</addtitle><description>IMPORTANCE: Understanding the factors associated with nasolacrimal duct probing failure in young children may help inform practice patterns. OBJECTIVE: To identify factors associated with repeated nasolacrimal duct probing in young children. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study analyzed data from the Intelligent Research in Sight (IRIS) Registry for all children who underwent nasolacrimal duct probing before 4 years of age between January 1, 2013, and December 31, 2020. MAIN OUTCOMES AND MEASURES: The Kaplan-Meier estimator was used to assess the cumulative incidence of a repeated procedure within 2 years of the initial procedure. Hazard ratios (HRs) derived from multivariable Cox proportional hazards regression models were used to evaluate the association between repeated probing and patient age, sex, race and ethnicity, geographic region, operative side, laterality of obstruction, type of initial procedure, and surgeon volume. RESULTS: This study included 19 357 children (9823 [50.7%] male; mean [SD] age, 1.40 [0.74] years) undergoing nasolacrimal duct probing. The cumulative incidence of repeated nasolacrimal duct probing was 7.2% (95% CI, 6.8%-7.5%) within 2 years of the initial procedure. Among 1333 repeated procedures, the second procedure involved silicone intubation in 669 (50.2%) and balloon catheter dilation in 256 (19.2%). Among 12 008 children aged 1 year or younger, office-based simple probing was associated with a slightly higher probability of reoperation compared with facility-based simple probing (9.5% [95% CI, 8.2%-10.8%] vs 7.1% [95% CI, 6.5%-7.7%]; P < .001). In the multivariable model, a greater risk of repeated probing was associated with bilateral obstruction (HR, 1.48; 95% CI, 1.32-1.65; P < .001) and office-based simple probing (HR, 1.33; 95% CI, 1.13-1.55; P < .001), and a lower risk was associated with primary balloon catheter dilation (HR, 0.69; 95% CI, 0.56-0.85; P < .001) and procedures performed by high-volume surgeons (HR, 0.84; 95% CI, 0.73-0.97; P = .02). Age, sex, race and ethnicity, geographic region, and operative side were not associated with reoperation risk in the multivariable model. CONCLUSIONS AND RELEVANCE: In this cohort study, most children in the IRIS Registry undergoing nasolacrimal duct probing before 4 years of age did not require any additional intervention. Factors associated with lower risk of reoperation include surgeon experience, probing performed under anesthesia, and primary balloon catheter dilation.</description><subject>Age</subject><subject>Anesthesia</subject><subject>Balloon catheters</subject><subject>Balloon treatment</subject><subject>Catheters</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Dacryocystorhinostomy</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Intubation</subject><subject>Lacrimal Duct Obstruction - diagnosis</subject><subject>Lacrimal Duct Obstruction - therapy</subject><subject>Lacrimal gland and Nasolacrimal duct</subject><subject>Male</subject><subject>Minority & ethnic groups</subject><subject>Nasolacrimal Duct - surgery</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Silicones</subject><subject>Treatment Outcome</subject><issn>2168-6165</issn><issn>2168-6173</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkdtKwzAYgIMoTtQX8EIC3nizmUObppdjOhVExQNehixN14y0mUkq-PambA70Jqf_-w_kAwBiNMEI4auVbKVbN7GRtnV2QhChE4RQtgeOCGZ8zHBB93dnlo_AaQirRCCeKJofghFlnBHK2RH4mksVnQ9wGoJTRkZdwQ8TG_gog7NSedNKC697FeGzdwvTLeFcGtt7DaetS7dZY2zldQdNB2Oj4X0XtbVmqbsIX3TQ0qtmiL2aZTO8LE2I_vsEHNTSBn263Y_B-_zmbXY3fni6vZ9NH8YywySOq1oirWRVKFIqjipeKYaIUtWCpYXXlOJa1xlVZUkLlnGS8QUimlJaFjKnOT0Gl5u6a-8-ex2iaE1QaUDZadcHQQqOGSEoxwm9-IeuXO-7NJ0gHLE8Z5yWieIbSnkXgte1WA9f5L8FRmLQI_7qEYMeMehJqefbBv2i1dUu8VdGAs42QKqwi6beBCejP7IimPw</recordid><startdate>20230401</startdate><enddate>20230401</enddate><creator>Oke, Isdin</creator><creator>Elze, Tobias</creator><creator>Miller, Joan W</creator><creator>Lorch, Alice C</creator><creator>Hunter, David G</creator><creator>Elliott, Alexandra T</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20230401</creationdate><title>Factors Associated With Nasolacrimal Duct Probing Failure Among Children in the Intelligent Research in Sight Registry</title><author>Oke, Isdin ; Elze, Tobias ; Miller, Joan W ; Lorch, Alice C ; Hunter, David G ; Elliott, Alexandra T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a412t-dfa0ecad7c29c80d8dc602ccdb6ccd8f331fef43c9937648248b02e33397a5353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Age</topic><topic>Anesthesia</topic><topic>Balloon catheters</topic><topic>Balloon treatment</topic><topic>Catheters</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Dacryocystorhinostomy</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Intubation</topic><topic>Lacrimal Duct Obstruction - diagnosis</topic><topic>Lacrimal Duct Obstruction - therapy</topic><topic>Lacrimal gland and Nasolacrimal duct</topic><topic>Male</topic><topic>Minority & ethnic groups</topic><topic>Nasolacrimal Duct - surgery</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Silicones</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oke, Isdin</creatorcontrib><creatorcontrib>Elze, Tobias</creatorcontrib><creatorcontrib>Miller, Joan W</creatorcontrib><creatorcontrib>Lorch, Alice C</creatorcontrib><creatorcontrib>Hunter, David G</creatorcontrib><creatorcontrib>Elliott, Alexandra T</creatorcontrib><creatorcontrib>IRIS Registry Analytic Center Consortium</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of ophthalmology (1960)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oke, Isdin</au><au>Elze, Tobias</au><au>Miller, Joan W</au><au>Lorch, Alice C</au><au>Hunter, David G</au><au>Elliott, Alexandra T</au><aucorp>IRIS Registry Analytic Center Consortium</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors Associated With Nasolacrimal Duct Probing Failure Among Children in the Intelligent Research in Sight Registry</atitle><jtitle>Archives of ophthalmology (1960)</jtitle><addtitle>JAMA Ophthalmol</addtitle><date>2023-04-01</date><risdate>2023</risdate><volume>141</volume><issue>4</issue><spage>342</spage><epage>348</epage><pages>342-348</pages><issn>2168-6165</issn><eissn>2168-6173</eissn><abstract>IMPORTANCE: Understanding the factors associated with nasolacrimal duct probing failure in young children may help inform practice patterns. OBJECTIVE: To identify factors associated with repeated nasolacrimal duct probing in young children. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study analyzed data from the Intelligent Research in Sight (IRIS) Registry for all children who underwent nasolacrimal duct probing before 4 years of age between January 1, 2013, and December 31, 2020. MAIN OUTCOMES AND MEASURES: The Kaplan-Meier estimator was used to assess the cumulative incidence of a repeated procedure within 2 years of the initial procedure. Hazard ratios (HRs) derived from multivariable Cox proportional hazards regression models were used to evaluate the association between repeated probing and patient age, sex, race and ethnicity, geographic region, operative side, laterality of obstruction, type of initial procedure, and surgeon volume. RESULTS: This study included 19 357 children (9823 [50.7%] male; mean [SD] age, 1.40 [0.74] years) undergoing nasolacrimal duct probing. The cumulative incidence of repeated nasolacrimal duct probing was 7.2% (95% CI, 6.8%-7.5%) within 2 years of the initial procedure. Among 1333 repeated procedures, the second procedure involved silicone intubation in 669 (50.2%) and balloon catheter dilation in 256 (19.2%). Among 12 008 children aged 1 year or younger, office-based simple probing was associated with a slightly higher probability of reoperation compared with facility-based simple probing (9.5% [95% CI, 8.2%-10.8%] vs 7.1% [95% CI, 6.5%-7.7%]; P < .001). In the multivariable model, a greater risk of repeated probing was associated with bilateral obstruction (HR, 1.48; 95% CI, 1.32-1.65; P < .001) and office-based simple probing (HR, 1.33; 95% CI, 1.13-1.55; P < .001), and a lower risk was associated with primary balloon catheter dilation (HR, 0.69; 95% CI, 0.56-0.85; P < .001) and procedures performed by high-volume surgeons (HR, 0.84; 95% CI, 0.73-0.97; P = .02). Age, sex, race and ethnicity, geographic region, and operative side were not associated with reoperation risk in the multivariable model. CONCLUSIONS AND RELEVANCE: In this cohort study, most children in the IRIS Registry undergoing nasolacrimal duct probing before 4 years of age did not require any additional intervention. Factors associated with lower risk of reoperation include surgeon experience, probing performed under anesthesia, and primary balloon catheter dilation.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>36862386</pmid><doi>10.1001/jamaophthalmol.2023.0004</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Anesthesia Balloon catheters Balloon treatment Catheters Child Child, Preschool Children Cohort analysis Cohort Studies Dacryocystorhinostomy Ethnicity Female Humans Infant Intubation Lacrimal Duct Obstruction - diagnosis Lacrimal Duct Obstruction - therapy Lacrimal gland and Nasolacrimal duct Male Minority & ethnic groups Nasolacrimal Duct - surgery Regression analysis Retrospective Studies Silicones Treatment Outcome |
| title | Factors Associated With Nasolacrimal Duct Probing Failure Among Children in the Intelligent Research in Sight Registry |
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