Goldberg Robert A, Samimi David B, Tsirbas Angelo, Douglas Raymond S
Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7006, USA.
Ophthalmic Plast Reconstr Surg. 2008 Mar-Apr;24(2):85-9. doi: 10.1097/IOP.0b013e318166f570.
To present the results of dacryocystorhinostomy with the use of a newly designed hydrogel lacrimal stent for repair of acquired nasolacrimal duct obstruction.
Noncomparative interventional case series. Twenty-three cases of acquired nasolacrimal duct obstruction confirmed by probing and irrigation underwent dacryocystorhinostomy using the hydrogel lacrimal stent. Tearing symptoms, functional endoscopic dye test, and anatomic appearance of ostia were noted at follow-up.
Five of 23 ostia closed during the postoperative period (1-3 months), translating to a late success rate of 78.3%. The 5 failed cases were treated successfully with ostium revision, 1 case requiring 2 revisions. All patients had endoscopic follow-up with a minimum follow-up of 6 months after stent removal. In the successful cases we noted a large, quiet ostium with good separation of the nasal septum and middle turbinate. Eleven cases (47.8%) had history of previously failed dacryocystorhinostomy surgery, chronic sinusitis, deviated septum, or maxillofacial surgery. There were no complications or reports of unusual pain or symptoms associated with the stent itself.
Early experience suggests the hydrogel lacrimal stent is a well-tolerated, effective tool for dacryocystorhinostomy surgery after acquired nasolacrimal duct obstruction. The device may serve as a useful surgical tool by holding open the ostium, maintaining apposition of the mucosal edges, and decreasing the incidence of nasal adhesions.
