Original ArticlesBalloon catheter dilation for treatment of adults with partial nasolacrimal duct obstruction: a preliminary report1
Section snippets
Methods
Between May 1996 and February 1997, balloon catheter dilation was performed prospectively on a series of 16 partially obstructed nasolacrimal systems in 14 adult patients with moderate to severe epiphora. One patient with unilateral obstruction died 5 months after the procedure from causes unrelated to lacrimal drainage obstruction or its treatment; this patient was eliminated from the study. Partial obstruction of the nasolacrimal system was defined as a negative Jones-1 test and canalicular
Results
Two weeks following balloon catheter dilation, with silicone intubation in place, 11 of 13 patients with obstructions experienced relief of symptoms. Silicone tubing was removed 2 months after the procedure. The results are given in the Table. Saline irrigation at the 2-month follow-up examination disclosed completely open nasolacrimal systems in 11 of 15 obstructions, for an objective success rate of 73%. Subjectively, eight of 16 obstructions had no tearing (grade 0), and five had grade 1
Discussion
In the majority of cases, acquired nasolacrimal duct obstruction in adults appears to be caused by age-related stenotic changes and low-grade infection of the lacrimal drainage system. Stenosis may predispose the sac and duct to stasis and infection, which causes thickening and folding of the mucosal wall, resulting in further narrowing of the lumen.24, 25 By mechanically restoring patency, balloon catheter dilation may break this cycle of stasis and inflammation, allowing the soft tissue to
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The authors have no financial support and no proprietary interest in any of the products described in this study.
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