title: Randomized comparison of nasolacrimal cryoplasty versus plastic lacrimal stenting in the management of epiphora in adults.
abstract: OBJECTIVE
  To evaluate the efficacy of plastic polyurethane stents compared with nasolacrimal cryoplasty in the management of epiphora in adults.
  
  
  METHODS
  Patients (N = 37; mean age, 64 years; range, 34-86 y; six men, 31 women) with severe epiphora with partial/complete obstruction of the nasolacrimal system were randomized to have a plastic stent inserted (n = 19) or to undergo balloon dilation cryoplasty (n = 18). Both procedures were conducted on an outpatient basis. Patency was assessed with Kaplan-Meier curves.
  
  
  RESULTS
  Initial technical success rate and immediate resolution of epiphora was complete in all cases. At 6 months of follow-up, outcomes were already significantly different between the treatment groups and hence the study was discontinued. Plastic stent placement achieved a primary patency rate of 59.6% at 6 months, compared with 12.4% in the cryoplasty group (P < .0004). Multivariate analysis indicated that other measured variables (sex, age, etiology, previous treatment, and the interventional radiologist's expertise) had no significant effect on the outcomes (P > .05).
  
  
  CONCLUSIONS
  Initial success was good in both treatment groups, with nasolacrimal plastic stent placement achieving a level of primary patency superior to the cryoplasty procedure for the relief of epiphora on short-term follow-up. However, long-term outcome evaluation is needed before stent placement can be recommended as an alternative to more established surgical procedures.
authors: Department of Interventional Radiology, Hospital Virgen de Salud, Complejo Hospitalario de Toledo, Avenida de Barber 30, 45004 Toledo, Spain. clanciego@eresmas.com
authors: Carlos
authors: C
authors: Lanciego
authors: Sofía
authors: S
authors: Navarro
authors: Javier
authors: J
authors: Velasco
authors: Miguel
authors: M
authors: Perea
authors: Rafael
authors: R
authors: Cuena-Boy
authors: Lorenzo
authors: L
authors: García-García
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007766:Lacrimal Apparatus Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011140:Polyurethanes; D011474:Prosthesis Design; D015641:Radiography, Interventional; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D011140:Polyurethanes