The polyurethane nasolacrimal duct stent for lower tear duct obstruction: long-term success rate and complications

Published on Sep 1, 2000in Graefes Archive for Clinical and Experimental Ophthalmology2.396
路 DOI :10.1007/S004170000187
Ulrich Schaudig11
Estimated H-index: 11
(UHH: University of Hamburg),
Rainer Maas1
Estimated H-index: 1
Sources
Abstract
Background: The polyurethane nasolacrimal duct stent is used as an alternative to conventional techniques for treatment of lower tear duct obstruction. The aim of this study was to evaluate the clinical success rate after a follow-up of 2 years. Methods: Nasolacrimal duct stent implantation was attempted in 19 patients with nasolacrimal duct obstruction proven by digital substraction dacryocystography. The median age of the patients was 50 years, and the minimum duration of symptoms was 3 months. Patients were followed up 1 week, 6 months, 1 year and 2 years after the procedure. Results: Eighteen stents were implanted in 17 patients without surgical complications. All stents were proven to be patent at the end of the procedure. Success rate, defined as proportion of patients free of symptoms, was 66.6%, 55.5% and 50% after 1 week, 6 months and 1 year, respectively, and remained unchanged thereafter. Three stents had to be removed between 6 months and 2 years after implantation. Histological examination showed granulation tissue growing into the opening and obstructing the stent in one case. Conclusion: Implantation of a polyurethane nasolacrimal duct stent is an alternative to conventional techniques in lower tear duct obstruction. Its overall success rate is lower than that reported after conventional dacryocystorhinostomy, but the procedure is fast, safe and reversible. Refinement of the surface and stent design may improve results in the future.
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References7
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#1Andreas B. Thale (CAU: University of Kiel)H-Index: 17
#2F. Paulsen (CAU: University of Kiel)
Last. Bernhard Tillmann (CAU: University of Kiel)H-Index: 50
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路 Background: The mechanism of lacrimal drainage under physiological conditions is controversial. The aim of this study was to analyze the three-dimensional architecture of human efferent tear ducts from functional and clinical points of view. A new theory of tear outflow is discussed. 路 Methods: Thirty-two prepared lacrimal systems of adults were examined by histological, immunohistochemical and scanning electron microscopic techniques. 路 Results: The wall of the lacrimal sac is made up of coll...
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PURPOSE: Evaluation of radiation dose to the radiosensitive head and neck organs and tissues-ocular lens, parotid and thyroid glands--during dacryocystography and fluoroscopy--guided dacryocystoplasty (DCP). METHOD: Radiation dose was determined in an Alderson Rando phantom and in 13 patients. Radiation dose was measured directly using Ca-F2-thermoluminescent dosimetry crystals (TLD) which were placed on each eyelid, parotid gland and thyroid gland. RESULTS: The mean radiation dose to the lens p...
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PURPOSE: To evaluate treatment of epiphora caused by obstructions of the nasolacrimal duct system with balloon dilatation and stent implantation. MATERIAL AND METHODS: 28 dacryocystoplasties were performed in 20 patients with complete (n = 7) or incomplete (n = 13) obstruction of the nasolacrimal duct system. RESULTS: Dacryocystoplasty was technically successful performed in 26 cases (93%). Recanalisation was not achieved in two patients with complete obstructions. 17 patients showed complete or...
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#1Ho Young Song (UOU: University of Ulsan)H-Index: 15
#2Y H JinH-Index: 1
Last. K B SungH-Index: 1
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PURPOSE: To evaluate the long-term effectiveness of a polyurethane stent in the treatment of obstruction of the lacrimal sac and the nasolacrimal duct. MATERIALS AND METHODS: Fluoroscopically guided placement of a polyurethane nasolacrimal stent was evaluated in 283 obstructed lacrimal systems of 236 patients, with a follow-up period of more than 1 year (range, 52-134 weeks). The obstruction was at the junction between the lacrimal sac and the nasolacrimal duct in 192 systems, at the lacrimal sa...
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#1Kristin J. Tarbet (WashU: Washington University in St. Louis)H-Index: 1
#2Philip L. Custer (WashU: Washington University in St. Louis)H-Index: 22
Background: External dacryocystorhinostomy (DCR) is the standard treatment for nasolacrimal duct obstruction, with success rates consistently above 90%. This study reviews the demographics, success, cost, efficiency, and patient satisfaction in external DCR. This information will be useful as comparison criteria for evaluating new surgical techniques. Methods: Records of 169 external DCR procedures performed over an 8.7-year period were reviewed. All patients had preoperative symptoms of tearing...
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#1Ho Young Song (UOU: University of Ulsan)H-Index: 15
#2Yong Han Jin (UOU: University of Ulsan)H-Index: 3
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PURPOSE: To describe the placement of a nasolacrimal polyurethane stent with a new introducer set and hook. MATERIALS AND METHODS: The authors designed a soft polyurethane stent, an introducer that does not require balloon dilation, and a hook that can remove a ball-tipped guide wire from the inferior nasal meatus under fluoroscopic guidance. The stent was placed in 51 lacrimal systems in 44 outpatients who had complete obstruction of the lacrimal sac or nasolacrimal duct. RESULTS: Stent placeme...
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Epiphora is a relatively common ophthalmologic affection representing almost 5% of clinical consultations in ophthalmology and it consists in the complete or partial obstruction of nasolacrimal duct, leading to insufficient drainage of tears. The traditional treatment is represented by surgery namely, external dacryocystorhinostomy (DCR). Despite the high success rate DCR has many disadvantages and limitations since it requires general anesthesia, it may arise in a permanent facial scar and it i...
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#1Ulrich LachmundH-Index: 3
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The complete diagnostic workup of the lacrimal drainage system is fast becoming of more interest to the combined team of radiologist and ophthalmologist, who are using different new techniques to treat the lacrimal system disorders. Radiological interventions to treat the lacrimal system and other new techniques used by ophthalmologists are now well established for treatments in selected cases. To identify patients suitable for interventional therapy, the exact cause for epiphora has to be deter...
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#1Jae Yeong Park (PNU: Pusan National University)H-Index: 2
#2Jong Soo Lee (PNU: Pusan National University)H-Index: 17
Purpose: In the present study, we cultured specimens and evaluated the types of bacteria existing at the stent and their antibiotic sensitivities from removed nasolacrimal polyurethane stents (Song's stents) due to recurrent inflammation or Song's stent obstruction after placement of Song's stents without fluoroscopic guidance for the treatment of obstructed nasolacrimal ducts. Methods: In 11 eyes of 11 patients who received Song's stent intubation to resolve nasolacrimal duct obstruction, the S...
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(Not yet perforated) membranous obstruction of the 鈥 ostium of the nasolacrimal duct at the level of the valve of Hasner (neonates 鈥 children) Post-infl ammatory stenoses (usually in the nasolac鈥 rimal duct, less often in the canaliculi) Dacryoliths in the lacrimal sac [97] 鈥 Tumours of the lower lacrimal drainage system 鈥 [18, 80] Nasal and paranasal sinus tumours 鈥 Extensive chronic polypoid sinusitis 鈥 Chronic infl ammatory conditions such as sarcoido鈥 sis [1, 15] Status post-midface fracture...
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#1Kai Wilhelm (University Hospital Bonn)H-Index: 22
#2B. Grabolle (University Hospital Bonn)H-Index: 1
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The purpose of this study was to evaluate the radiographic and biological effects of different polyurethane nasolacrimal duct stents in an animal model. Fifteen polyurethane nasolacrimal duct stents (n = 5 mushroom-type stents, n = 5 newly designed S-shaped TearLeader stents without hydrophilic coating, and n = 5 S-shaped TearLeader stents with hydrophilic coating) were implanted in the nasolacrimal ducts of eight unaffected New Zealand rabbits. One nasolacrimal system served as control. Clinica...
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Purpose To present 5-year results of polyurethane stent implantation for treatment of postsaccal lacrimal duct stenoses.
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#1Selim Doganay (陌n枚n眉 University)H-Index: 21
#2Kaya Sara莽 (陌n枚n眉 University)H-Index: 16
Last. Yasar CokkeserH-Index: 11
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A Song's nasolacrimal duct stent was placed in a patient with epiphora due to primary nasolacrimal duct obstruction and the stent was kept for 32 months. Mitomycin C 0.02% eye drops four times a day were prescribed for four weeks following polyurethane stent placement procedure. No epiphora-related complaints occurred for thirty months after then the epiphora started. Nasolacrimal stent was removed from nasal cavity endoscopially and the tissues within the extruded stent were examined histopatho...
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#1Erhan T. Ilgit (Gazi University)H-Index: 17
#2Baran 脰nal (Gazi University)H-Index: 13
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This article presents a review of the interventional radiological procedures in the lacrimal drainage system. Balloon dacryocystoplasty and nasolacrimal polyurethane stent placement are the main fluoroscopically guided interventions for the treatment of epiphora by recanalizing the obstructed LDS. These procedures can also be used for dacryolith removal and lacrimal sac abscess treatment.
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#1Ulrich Lachmund (Kantonsspital St. Gallen)H-Index: 3
#2D. Ammann-Rauch (Kantonsspital St. Gallen)H-Index: 1
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Hintergrund Untersuchung der klinischen Effizienz der Ballonkatheterdilatation bzw. Stentimplantation bei Obstruktionen des Tranengangsystems.
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#1Ulrich LachmundH-Index: 3
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