[Indications and contraindications of lacrimal duct balloon dilatation]

The aim of the study was to determine the indications and contraindications for balloon dacryocystoplasty.

So far 85 patients with severe epiphora because of relative stenosis (n = 47) or occlusion (n = 38) of the nasolacrimal duct have undergone dilation. The success rates were evaluated during the acute phase and the follow-up period of 6-12 months. Treatment failures and recurrence of stenosis were analyzed and compared to the clinical and dacryocystographic indications prior to treatment.

A recanalization success rate of 79% was achieved in patients with isolated postsaccal stenoses or short-distance occlusions of the nasolacrimal duct. Patients with additional presaccal and saccal stenoses, filling defects in the duct lumen, or long-distance occlusions had lower initial recanalization rates (66%). Main predictors for recurrent obstructions were active inflammation, filling defects due to calculi, extensive occlusion and post-traumatic lesions. In the absence of these factors 12-month patency rates of 80% were proved.

Dacryocystoplasty procedures should preferably be performed in patients with circumscribed functional postsaccal stenosis. In these cases a success rate of about 80% is possible. Otherwise the value of the intervention is limited by high failure and recurrence rates.