Nasolacrimal stents in the management of epiphora: Medium-term results of a multicenter prospective study

PURPOSE: To evaluate in a prospective multicenter setting the clinical util ity of polyurethane stents in the percutaneous management of epiphora. MATERIALS AND METHODS: Patients (N = 163; age range = 22-85 y, mean = 52 y; 29 men, 134 women) with severe epiphora had stents (n = 183) inserted unde r fluoroscopic guidance in 180 lacrimal systems (unilateral = 146; bilatera l = 17) to treat complete (n = 172) or partial (n = 8) obstruction of the n asolacrimal duct or sac. The junction between sac and duct was the most fre quent location (n = 102), followed by the sac alone (n = 48), and the duct alone (n = 30). The etiology of the obstruction was idiopathic in 113 cases (63%) and chronic dacryocystitis in 67 (37%). The set designed by Song was used in all patients and the original technique was slightly modified by t he authors. All patients were treated on an outpatient basis. Average time of the procedure was 14 minutes (range = 3-70 min). RESULTS: Initial technical success rate of stent placement was 97%. Resolut ion of epiphora was complete in 175 eyes and partial in five. On follow-up (mean = 450 d; range = 8-730 d), 157 of 183 stents remained patent (85.8%). Of the 24 obstructed, 19 were easily withdrawn and 17 of these patients re mained asymptomatic for a mean of 15 months (secondary patency rate = 89.5% ). CONCLUSIONS: The procedure is simple and safe. It can be performed on an ou tpatient basis and the original technique could be improved with some techn ical modifications. It is well tolerated by patients and may be considered as a valid alternative technique for the resolution of epiphora.