The polyurethane nasolacrimal duct stent for lower tear duct obstruction: long-term success rate and complications

Background: The polyurethane nasolacrimal duct stent is used as an alternat ive to conventional techniques for treatment of lower tear duct obstruction . The aim of this study was to evaluate the clinical success rate after a f ollow-up of 2 years. Methods: Nasolacrimal duct stent implantation was atte mpted in 19 patients with nasolacrimal duct obstruction proven by digital s ubstraction dacryocystography. The median age of the patients was 50 years, and the minimum duration of symptoms was 3 months. Patients were followed up I week, 6 months, 1 year and 2 years after the procedure. Results: Eight een stents were implanted in 17 patients without surgical complications. Al l stents were proven to be patent at the end of the procedure. Success rate , defined as proportion of patients free of symptoms, was 66.6%, 55.5% and 50% after 1 week, 6 months and 1 year, respectively, and remained unchanged thereafter. Three stents had to be removed between 6 months and 2 years af ter implantation. Histological examination showed granulation tissue growin g into the opening and obstructing the stent in one case. Conclusion: Impla ntation of a polyurethane nasolacrimal duct stent is an alternative to conv entional techniques in lower tear duct obstruction. Its overall success rat e is lower than that reported after conventional dacryocystorhinostomy, but the procedure is fast, safe and reversible. Refinement of the surface and stent design may improve results in the future.