Indications and contraindications for balloon dacryocystoplasty

Purpose: The aim of the study was to determine the indications and contrain dications for balloon dacryocystoplasty. Material and methods: So far, 85 patients with severe epiphora because of r elative stenosis (n = 47) or occlusion (n = 38) of the nasolacrimal duct ha ve undergone dilation. The success rates were evaluated during the acute ph ase and the follow-up period of 6-12 months. Treatment failures and recurre nce of stenosis were analyzed and compared to the clinical and dacryocystog raphic indications prior to treatment. Results: A recanalization success rate of 79 % was achieved in patients wit h isolated postsaccal stenoses or short-distance occlusions of the nasolacr imal duct. Patients with additional presaccal and saccal stenoses, filling defects in the duct lumen, or long-distance occlusions had lower initial re canalization rates (66 %). Main predictors for recurrent obstructions were active inflammation, filling defects due to calculi, extensive occlusion an d post-traumatic lesions. In the absense of these factors 12-month patency rates of 80 % were proved. Conclusion: Dacryocystoplasty procedures should preferably be performed in patients with circumscribed functional postsaccal stenosis. in these cases a success rate of about 80% is possible. Otherwise the value of the interve ntion is limited by high failure and recurrence rates.