Congenital lacrimal system obstruction: Treatment with balloon dilation

PURPOSE: To evaluate the safety and effectiveness of balloon dilation for t he treatment of congenital lacrimal system obstruction. MATERIALS AND METHODS: Fluoroscopically guided balloon dilation was attempt ed in 20 eyes of 16 patients with an age range of 12-78 months (mean, 33 mo ) for congenital lacrimal system obstruction. Fifteen eyes had complete obs truction at the valve of Hasner, three eyes had completely obstruction at t he junction between the lacrimal sac and the nasolacrimal duct, and two eye s had partial obstruction at the nasolacrimal duct, Under general anesthesi a, a ball-tipped guide wire was introduced through the superior punctum int o the inferior meatus of the nasal cavity and pulled out through the naris with use of a hook. A deflated 3-mm-diameter balloon catheter was then adva nced in a retrograde direction and the balloon was dilated. Every patient u nderwent an ophthalmic evaluation before the procedure and was scheduled to he followed with office examination at 1, 3, and 6 months after the proced ure. RESULTS: There were no major complications. "Technical success" was defined as free passage of contrast medium through the entire lacrimal system to t he nasal cavity, The procedure failed in one eye. After balloon dilation, a ll 19 eyes in which technical success was achieved showed improvement of ep iphora, During the follow-up period of 2-33 months (mean, 16 mo), all eyes maintained improvement of epiphora and needed no further treatment. CONCLUSION: Balloon dilation is a safe and effective therapeutic technique for the treatment of congenital lacrimal system obstruction.