TREATMENT OF RECURRENT NASOLACRIMAL DUCT OBSTRUCTIONS WITH BALLOON-EXPANDABLE METALLIC STENTS - RESULTS OF EARLY EXPERIENCE

PURPOSE: To evaluate the efficacy of Palmaz balloon-expandable metalli c stents for the maintenance of luminal patency in the treatment of re current nasolacrimal duct obstructions after failed transluminal ballo on dilatation. METHODS: Metallic stents were implanted in the nasolacr imal duct of four patients with recurrent epiphora. All the patients h ad already undergone transluminal balloon dilatation of the nasolacrim al duct with no or only temporary improvement. In two eyes, 9.5-mm-lon g Palmaz stents were used; in the other two eyes, 20-mm-long articulat ed-design Palmaz stents were placed under digital fluoroscopic monitor ing. In each case, the upper tip protruded slightly into the lacrimal sac and the lower end was positioned inside the nasolacrimal duct. RES ULTS: The stents were placed accurately in all cases, and no complicat ions were observed. After stent placement, all patients had complete r esolution of epiphora. During the follow-up period of 10 months, altho ugh complete obstruction did not occur in any case, complete resolutio n of epiphora was maintained only in one of four eyes. In two eyes, im provement was remarkable. In one eye with partial improvement, intrast ent balloon dilatation was performed. CONCLUSION: Treatment of recurre nt nasolacrimal duct obstructions with balloon-expandable metallic ste nts is a noninvasive, efficient, and safe outpatient procedure that ma y be an alternative to surgery as a means for managing epiphora.