Clinical efficacy of the polyurethane stent without fluoroscopic guidance in the treatment of nasolacrimal duct obstruction

Purpose: To evaluate the clinical efficacy of the polyurethane (Song) stent in the treatment of nasolacrimal duct obstruction without fluoroscopic gui dance, especially at the junction between the lacrimal sac and nasolacrimal duct or at the nasolacrimal duct. Design: Retrospective noncomparative case series. Participants: This study evaluated 59 cases of nasolacrimal duct obstructio n in 53 patients, with mean epiphora of 36 months (range, 2 months-17 years ). Methods: Without the assistance of a radiologist, a polyurethane nasolacrim al stent was placed by introducing a guidewire through the superior or infe rior punctum into the canaliculus and advancing it across the obstruction i nto the opening of the inferior meatus of the nasal cavity. The mean follow -up period was 22 months (range, 12 months-48 months). Main Outcome Measures: Patency of the lacrimal passage to irrigation and th e duration of this procedure. Results: Complete resolution of epiphora was accomplished in 55 (93.2%) of the 59 eyes. There was recurrence of epiphora in four cases because of obst ruction of the stent in three cases and obstruction of the common canalicul us by recurrent dacryocystitis in one case. Conclusions: Polyurethane stenting without fluoroscopic guidance seems to b e a valuable technique for primary management of nasolacrimal duct obstruct ion before dacryocystorhinostomy. Ophthalmology 2000; 107:1666-1670 (C) 200 0 by the American Academy of Ophthalmology.