Long-term results and factors affecting patency after removal of nasolacrimal stents.
OBJECTIVE
To retrospectively evaluate the long-term patency and prognostic factors affecting patency after removal of nasolacrimal stents.


METHODS
Lacrimal polyurethane stents were removed from 317 lacrimal drainage systems of 275 patients because the stent ceased to function, and immediate and maintained patency were determined with follow-up dacryocystography (DCG) after stent removal. Prognostic factors for patency after stent removal were evaluated by univariate and multivariate analyses for immediate patency and Kaplan-Meier survival analysis and multivariate analysis for maintained patency.


RESULTS
All stents were successfully removed under fluoroscopic or endoscopic guidance. After stent removal, 243 lacrimal systems (77%) showed immediate patency. The size of the lacrimal sac was the same (65% of cases), widened (2%), or contracted (33%) after stent removal. The shape of the lacrimal sac was normal in 30% and irregular in 70% of cases after stent removal. Seven-day follow-up DCG was obtained in 169 cases, and maintained patency of the lacrimal system was confirmed on 7-day follow-up DCG in 125 cases. Epiphora recurred in 70 cases (56%) during the mean 8-month follow-up period (range, 1-48 months). The mean maintained patency period after stent removal was 15.7 +/- 2.1 months. The maintained patency rates were 41% at 1 year, 31% at 2 years, and 14% at 4 years after stent removal. Multivariate analysis showed that the size of the lacrimal sac (P < .001) was the only factor affecting immediate and maintained patency after stent removal.


CONCLUSIONS
After stent removal in patients with nasolacrimal stent obstruction, the immediate patency rate was 77%; however, the rate of maintained patency decreased progressively with time. The major factor negatively affecting immediate and maintained patency after stent removal was contraction of the lacrimal sac at the time of stent removal.
Kim
Jin Hyoung
JH
Department of Radiology, Armed Forces Byukjae Hospital, Goyang, Korea.
Shin
Ji Hoon
JH
Song
Ho-Young
HY
Kang
Weechang
W
Lim
Jin-Oh
JO
Park
Seong Ho
SH
Ko
Gi Young
GY
Yoon
Hyun-Ki
HK
Sung
Kyu Bo
KB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D020878:Device Removal; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct; D011140:Polyurethanes; D011379:Prognosis; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents
D011140:Polyurethanes