Evaluation of polyurethane stent implantation for the treatment of complete obstruction of the nasolacrimal system: 8-month follow-up and complications

Dacryocystorhinostomy is still the standard procedure complete stenosis of the nasolacrimal duct. New methods try to preserve the natural lacrimal pat hway. Song implanted in 1995 a nasolacrimal polyurethane stent through the nasolacrimal duct. The results and complications of this new method are des cribed in this prospective study. Methods: Thirty consecutive patients with complete obstruction of the nasol acrimal duct or lacrimal sac were included in the study. The stenosis was l ocalized by dacryocystography. The ages ranged from 22 to 87 years (mean, 5 8.9 +/- 16 years). Dacryocystography was performed immediately, 4 weeks and 8 months after the procedure to verify the position and patency of the ste nt. Results: Twenty-five short (35 mm) and 5 long (45 mm) stents were implanted . Twenty-four of 30 patients after 4 weeks and 9 of 10 patients after 8 mon ths had reduced or no complaints. In 1 patient the stent was obstructed. Fo rceful irrigation with saline solution permitted recanalization. In 1 patie nt the stent had moved into the upper canaliculus. Because of irritation of the canaliculus it had to be pulled out after 2 months. Conclusion: The follow-up is still too short to recommend stent implantatio n as a real alternative to dacryocystorhinostomy. The main advantages are t hat the procedure is faster, no incision is necessary, and the local anesth esia is easier. The disadvantage is the need for X-ray examination.