Dilatation and stenting for naso-lacrimal duct obstruction: a pilot project.
OBJECTIVE
Obstruction of the naso-lacrimal duct has traditionally been treated by dacryocystorhinostomy. This pilot project aimed to evaluate the use of stents as an alternative approach to the treatment of naso-lacrimal duct obstruction.


METHODS
Six patients with naso-lacrimal duct obstruction underwent a pre-procedural dacryocystogram to confirm the site of obstruction. Under local anaesthesia, they subsequently underwent dilatation of the naso-lacrimal duct using a guide wire and a plastic dilator aided by fluoroscopy and digital subtraction imaging. The stent was then placed with its head in the lacrimal sac and tail protruding out of the naso-lacrimal duct into the inferior meatus. Dacryocystography was repeated to confirm patency. Patients were followed up for a minimum of 12 months.


RESULTS
The procedure was successfully completed in four of the six patients. In one patient, we failed to negotiate the guide wire and in one, a false passage was created. All four successful cases were rendered asymptomatic and their lacrimal passages remained patent at 12 months.


CONCLUSIONS
Naso-lacrimal duct dilatation and stenting is a viable alternative to conventional dacryocystorhinostomy in the treatment of naso-lacrimal duct obstruction and merits a larger trial.
Shankar
J
J
Department of Ophthalmology, Inverclyde Royal Hospital, Greenock, Scotland, United Kingdom. jai.shankar@tesco.net
Gupta
S R
SR
Walsh
P
P
D000368:Aged; D003608:Dacryocystorhinostomy; D004106:Dilatation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome