BALLOON DACRYOCYSTOPLASTY - INDICATIONS AND CONTRAINDICATIONS

PURPOSE: To define the indications and contraindications for balloon d acryocystoplasty. MATERIALS AND METHODS: Eighty-five patients with sev ere epiphora due to partial (n = 47) or complete (n = 38) obstruction of the nasolacrimal duct (NLD) were treated with balloon dacryocystopl asty (DCP). Steerable micro-guide wires with flexible tips were used. Success rates of DCP were evaluated clinically and dacryocystographica lly during the acute phase and at 6- and 12-month follow-up. Failures and recurrences were correlated with clinical and dacryocystographic i ndications for treatment. RESULTS: Recanalization was successful in 35 (92%) of 38 patients with isolated focal stenoses (n = 20) or short-d istance occlusions (n = 18) of the NLD. Among all 85 patients, recanal ization was successful in 25 patients (66%) with complete and 37 patie nts (79%) with partial obstructions. In the absence of the main predic tors for recurrent obstructions (ie, active inflammation, filling defe cts due to calculi, long-distance occlusions, and posttraumatic lesion s), 12-month patency rates were 89% (17 of 19 focal stenoses) and 94% (15 of 16 focal occlusions). Otherwise, reobstruction rate was 46% (12 of 26 cases). CONCLUSION: Balloon dacryocystoplasty is successful onl y in select cases. To achieve results comparable to those of operative treatment, the indication should be limited to patients with circumsc ribed focal stenoses or occlusions of the NLD. Active dacryocystitis, dacryocystolithiasis, and posttraumatic lesions are the main contraind ications.