Balloon dacryocystoplasty: indications and contraindications.
OBJECTIVE
To define the indications and contraindications for balloon dacryocystoplasty.


METHODS
Eighty-five patients with severe epiphora due to partial (n = 47) or complete (n = 38) obstruction of the nasolacrimal duct (NLD) were treated with balloon dacryocystoplasty (DCP). Steerable micro-guide wires with flexible tips were used. Success rates of DCP were evaluated clinically and dacryocystographically during the acute phase and at 6- and 12-month follow-up. Failures and recurrences were correlated with clinical and dacryocystographic indications for treatment.


RESULTS
Recanalization was successful in 35 (92%) of 38 patients with isolated focal stenoses (n = 20) or short-distance occlusions (n = 18) of the NLD. Among all 85 patients, recanalization was successful in 25 patients (66%) with complete and 37 patients (79%) with partial obstructions. In the absence of the main predictors for recurrent obstructions (ie, active inflammation, filling defects due to calculi, long-distance occlusions, and posttraumatic lesions), 12-month patency rates were 89% (17 of 19 focal stenoses) and 94% (15 of 16 focal occlusions). Otherwise, reobstruction rate was 46% (12 of 26 cases).


CONCLUSIONS
Balloon dacryocystoplasty is successful only in select cases. To achieve results comparable to those of operative treatment, the indication should be limited to patients with circumscribed focal stenoses or occlusions of the NLD. Active dacryocystitis, dacryocystolithiasis, and posttraumatic lesions are the main contraindications.
Berkefeld
J
J
Institute of Neuroradiology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
Kirchner
J
J
Müller
H M
HM
Fries
U
U
Kollath
J
J
D002404:Catheterization; D000075202:Contraindications; D003607:Dacryocystitis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D007767:Lacrimal Duct Obstruction / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct; D018579:Patient Selection; D010865:Pilot Projects; D011859:Radiography; D013997:Time Factors; D016896:Treatment Outcome