Nasolacrimal stents in the treatment of epiphora: long-term results.
OBJECTIVE
Assessment of the long-term results achieved with use of nasolacrimal stents in the treatment of epiphora caused by obstruction of the lacrimal apparatus. The role of stents in treating this condition is evaluated.


METHODS
From February 1997 to April 1999, a total of 89 procedures to insert nasolacrimal stents were performed in 77 patients (20 men, 57 women; mean age, 53 years). A total of 79 stents were successfully implanted, with 10 failures (11.2%). Postprocedural course was followed for 16-38 months (mean, 27 mo) by means of clinical examinations and/or periodic dacryocystography, with removal of occluded stents. On conclusion of the study in September 2000, dacryocystography was performed in all patients in whom stents were still in place.


RESULTS
Of the 79 stents deployed, two were lost, two had to be excluded from the study, 45 (60%) ceased to function, and 30 (40%) remained patent. Median duration of stent patency of these 79 stents was 20 months. Mean time to occlusion was 9.2 months for all obstructed stents; 4.4 months for improperly placed stents (via a trajectory outside the normal lacrimal drainage apparatus) and 12.2 months for stents that appeared to have been inserted properly. Of the 45 occluded stents, 40 were removed and five were left in place. Upon removal, adherence of the stents to the lacrimal apparatus was frequently observed.


CONCLUSIONS
The low patency rate and the difficulties encountered in removing nasolacrimal stents during the course of long-term placement calls into question the efficacy of this method as a definitive treatment for epiphora caused by obstruction of the lacrimal drainage system, although studies comparing this and other treatment modalities are needed. Assessment of temporary stent placement may be in order.
Paúl
Laura
L
Radiology Service, Section of Vascular and Interventional Radiology, Hospital Universitario de Getafe, Carretera de Toledo Km 12,5. 28905, Getafe, Madrid, Spain. laura.paul@teleline.es
Pinto
Isabel
I
Vicente
Jose Manuel
JM
Armendariz
Ana
A
Moreno
Gema
G
Baraibar
M Cruz
MC
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011140:Polyurethanes; D011475:Prosthesis Failure; D015607:Stents
D011140:Polyurethanes