Treatment of complete obstruction of the nasolacrimal system by temporary placement of nasolacrimal polyurethane stents: preliminary results

AIM: To assess the efficacy of the temporary placement of polyurethane nasolacrimal stents as a treatment for complete post-saccal obstruction of the lacrimal apparatus. MATERIALS AND METHODS: Polyurethane nasolacrimal stents were inserted under radiological guidance in nine patients with grade IV epiphora due to complete obstruction of the lacrimal system, at the junction of the lacrimal sac and duct (eight patients) or in the lacrimal duct (one patient). On average, the stents were removed 4 months (range: 3-6 months) after insertion. Dacryocystography was performed immediately before and after each stent was removed. Subsequently, periodic clinical and radiological examinations were performed until recurrence of the epiphora, at which point follow-up concluded. RESULTS: All patients remained free of epiphora and clinical inflammation while the stents were in place, but re-obstruction of the lacrimal system occurred in all patients less than 2 months after the stents were removed. Adhesion of three stents to the lacrimal tract was observed upon removal. In seven cases the dacryocystography results at the end of follow-up revealed changes in the configuration of the lacrimal apparatus. CONCLUSION: Based on our preliminary experience, temporary placement of polyurethane stents would not appear to be an efficacious therapeutic option for treating epiphora caused by post-saccal obstruction.