Long-term results of balloon dacryocystoplasty: success rates according to the site and severity of the obstruction

Abstract

Purpose To evaluate the long-term patency of lacrimal drainage system (LDS) after balloon dacryocystoplasty (BD) and to give the longterm success rates according to the severity and localization of the obstruction. Methods Between May 1993 and December 2003, BD was attempted in 117 eyes of 108 patients with idiopathic-acquired LDS obstruction. Patients with active dacryocystitis, dacryolithiasis, traumatic obstruction or lacrimal mass, obstructions at the superior or inferior canaliculi lateral to the common canaliculus, and follow-up period less than 36 months were excluded from the study.Results The results of BD were evaluated in 99 eyes of 94 cases. The obstruction was seen at the common canaliculus in seven eyes, proximal nasolacrimal duct in 70 eyes, and distal nasolacrimal duct in 22 eyes. The mean follow-up period was 100.0738.4 months (range: 36-142 months). The long-term overall success rate was 40.8% (20/49 eyes) in complete obstruction and 68% (34/50 eyes) in partial obstruction. The clinical success rate was 57.1% in common canalicular (complete: 33.3%, partial: 75%), 50% in proximal nasolacrimal duct (complete: 38.5%, partial: 64.5%), and 68.2% in distal nasolacrimal duct (complete: 57.1%, partial: 73.3%) obstructions. The overall success was 54.5% (54/99 eyes) for the entire series at the last clinical follow-up visit. Conclusion The long-tem success rate of BD for the treatment of epiphora is low and is not comparable to conventional dacryocystorhinostomy. More predictable results can only be achieved in carefully selected patients and this procedure can be recommended in cases demonstrating partial obstruction of the distal nasolacrimal duct.

External Dacryocystorhinostomy for the Treatment of Functional Nasolacrimal Drainage Obstruction

“…14,15,16,17 With the addition of silicone intubation and antegrade catheterization, Perry et al 18 documented patency rates of 73% with a shorter follow-up time of six months.…”

“…8,9,10,11,12,13 Balloon catheter dilatation with and without intubation has similar success rates ranging between 53 and 68%. 13,14,15,16,17,18 …”

Management of canalicular obstructions

“…Immediate clinical improvement can be achieved in 82% of cases and common canalicular obstructions have better prognosis than monocanalicular obstructions [20 ]. However, the long-term success rate of balloon canaliculoplasty for the treatment of common canalicular obstructions is low (57%) [21 ].…”

Assessment and management of proximal and incomplete symptomatic obstruction of the lacrimal drainage system

“…Some90 define the functional obstruction as (a) a negative Jones I and positive Jones II dye test, or (b) a freely patent nasolacrimal system to irrigation with minimum or no reflux from the upper canaliculus or punctum. At times, a technetium scan or dacryocystography assist in establishing the diagnosis and classification of NLD stenosis 709091. Based on lacrimal scintigraphy, a pre-sac delay is diagnosed if the tracer fails to reach the sac by the end of the dynamic phase.…”