Dietze J, et al. - In this retrospective, observational case-control clinical study, researchers identified common factors that could help predict if a child is at higher risk of surgical failure for nasolacrimal duct obstruction. Patient factors present prior to surgical intervention and their association with the necessity of multiple surgeries were reviewed for this analysis. Findings suggested that patients with trisomy 21 or a recent upper respiratory tract infection history can be linked to a higher risk of failure with a probing and irrigation surgery only. Due to an increased risk profile, patients with trisomy 21 may benefit from an initial balloon dilation procedure rather than probing and irrigation. Patients with a recent infection of the upper respiratory tract may benefit from postponing surgery until symptom treatment or resolution.