Balloon dacryocystoplasty is successful only in select cases. To achieve results comparable to those of operative treatment, the indication should be limited to patients with circumscribed focal stenoses or occlusions of the NLD. Active dacryocystitis, dacryocystolithiasis, and posttraumatic lesions are the main contraindications.

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Twenty-two patients with severe epiphora due to relative (n= 13) or absolute (n = 9) stenoses of the nasolacrimal duct were treated by means of radiologically guided balloon dacryocystoplasty. The recanalization was performed with a steerable microguide wire with flexible tip, which was advanced through the lacrimal draining system and manipulated out of the nasal cavity. A 3-mm PTA balloon was then introduced from the nasal site. In 20 of 22 cases the procedure was technically successful. Dacryocystography proved a normal lumen in 9 of 20 patients and an improvement without impairment of flow in another 8 cases. Two months after dilation a clear regression of epiphora could be demonstrated in 17 of 20 patients. The procedure was complicated by the occurrence of 2 reobstructions within the first 3 months; other serious side effects were not observed.

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