{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:14:37Z","timestamp":1790381677510,"version":"4.1.0"},"reference-count":18,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2023,12,23]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Congenital nasolacrimal duct obstruction (CNLDO) is the most common cause of epiphora and mucous discharge in the newborn. We conducted a multicentre randomised controlled trial to determine whether Crigler massage promotes the resolution of CNLDO in infants under 1 year of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 102 infants aged 3\u201311 months with unilateral CNLDO were enrolled in the study. Patients were randomly assigned to the massage and non-massage groups (n=51\/group). As an allocation adjustment factor, the patients were divided into age groups of 3\u20135, 6\u20138 and 9\u201311 months. In the massage group, the guardian performed 10 strokes two times per day for each day until resolution or 1\u2009month. The primary endpoint was a comparison of the 1-month resolution rate in the massage and non-massage groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study included 49 male and 53 female patients with a mean age of 6.4\u00b12.4 months. Overall, in this study, the resolution rate was not significantly different between the massage and non-massage groups (31.4% and 33.3%, respectively). However, the resolution rate was higher in the massage group in the 3\u20135\u2009months age group among the protocol-compliant patients after excluding those with insufficient massage frequency (the massage group, 68.8% and the non-massage group, 28.6%, p=0.022).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There was no increase in the resolution rate after 1\u2009month of lacrimal sac massage in patients 3\u201311\u2009months old with unilateral CNLDO. However, in protocol-compliant younger age groups, Crigler massage may be effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      UMIN Clinical Trial Registry (UMIN000032840;\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.umin.ac.jp\/\">www.umin.ac.jp\/<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2023-324595","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T13:25:15Z","timestamp":1705670715000},"page":"1281-1285","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Lacrimal sac massage for congenital nasolacrimal duct obstruction: a multicentre randomised controlled trial"],"prefix":"10.1136","volume":"108","author":[{"given":"Mizuki","family":"Asano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5494-0626","authenticated-orcid":false,"given":"Masaki","family":"Takeuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Ohno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5565-5050","authenticated-orcid":false,"given":"Jutaro","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhisa","family":"Mizuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nozomi","family":"Matsumura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"key":"2024082203451042000_108.9.1281.1","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1136\/bmj.315.7103.293","article-title":"Managing 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