EVALUATION OF POLYURETHANE STENT IMPLANTATION FOR THE TREATMENT OF COMPLETE OBSTRUCTION OF THE NASOLACRIMAL SYSTEM: 8-MONTHS FOLLOW-UP AND COMPLICATIONS
N. Anders1, K.-T. Hoffmann2, N. Hosten2, T. Walkow1, R. Felix2, Chr. Hartmann1
Dacryocystorhinostomy is still the standard procedure in case of a complete stenosis of the nasolacrimal duct. New methods try to preserve the natural lacrimal pathway. Song implanted in 1995 a nasolacrimal polyurethane stent through the nasolacrimal duct. The results and complications of this new method are described in this prospective study.
Methods. 20 consecutive patients with a complete obstruction of the nasolacrimal duct or lacrimal sac were included in the study. The stenosis was localized by dacryocystography. The ages ranged from 22 to 84 years (mean, 55 years). Follow-up ranged from 4 to 11 months (mean 7.5 m.). Dacryocystography was performed immediately, 4 weeks and 8 months after the procedure to verify the position and patency of the stent.
Results. 17 short (35 mm) and 3 long (45 mm) stents were implanted. 18 from 20 patients were treated with full success. The stent remained open, which could be confirmed with dacryocystography. In one patient the stent was obstructed and dacryocystitis reappeared. Forcefully irrigation with saline solution enabled recanalization. In one patient the stent had moved into the upper canaliculus. Because of irritation of the canaliculus it had to be drawn out.
Conclusion. The follow-up is still too short to recommend the stent implantation as a real alternative to the dacryocystorhinostomy. The main advantages are, that the procedure is faster, there is no incision necessary and the local anesthesia is easier. The disadvantages are the higher price and the need of X-ray examination.
1Dept. of Ophthalmology, Charite, Campus Virchow-Klinikum, D-13353 Berlin
2Dept. of Radiotherapy, Charite, Campus Virchow-Klinikum, D-13353 Berlin