Balloon dacryocystoplasty: Results and factors influencing outcome in 350 patients

PURPOSE: To evaluate the initial and long-term results of balloon dacryocys toplasty in the treatment of epiphora caused by obstruction of the lacrimal system with analysis of the procedure's favorable effects. MATERIALS AND METHODS: Four hundred thirty eyes of 350 patients with obstru ctions of the lacrimal system were enrolled. Dacryocystoplasty was performe d with use of a balloon catheter and a ball-tipped guide wire. The lesions were categorized according to cause, severity, site of the obstruction, and diameter and inflation time of the balloon. The technical success, initial success (improvement of symptoms after 1 week), and long-term patency rate s were calculated. These rates in each group were compared with the chi (2) test and the Kaplan-Meier method. RESULTS: The overall technical success rate was 95.3%. The overall initial success rate was 57.4%. There was no significant complication except for mi ld epistaxis in 12%. The 2-month, 1-year, and 5-year patency rates were 48. 2%, 39.4%, and 36.9%, respectively. Initial success was influenced by the s everity (P =.014) and the site (P <.001) of the obstruction, and the diamet er of the balloon (P =.047). Long-term patency was affected by the site of the obstruction (P <.001) and the balloon inflation time (P <.001). Among t he 183 initially ineffective and 88 recurrent cases, 62 underwent repeat ba lloon dacryocystoplasty, and the initial success rate was 38.7%. CONCLUSIONS: The initial success rate of balloon dacryocystoplasty is relat ively low. However, long-term patency can be expected in cases with initial success. Some additional factors also should be considered for better resu lts.