Dacryocystostenting: technical and long-term results

We describe our experience in treating epiphora caused by chronic inflammation and obstruction of the nasolacrimal system by endonasal placement of a polyurethane stent in the nasolacrimal duct, with long-term assessment of patency (4 years).

Between July 1998 and May 2001, 57 stents were inserted using Song's technique. All procedures were carried out in the radiology suite following mild sedation and local anaesthesia of the conjunctival and nasal mucosa. The follow-up investigation concerns 23 stents assessed 24-48 months after placement.

At follow-up after 4 years, 20 stents (86.9%) were obstructed. Fifteen of the stents removed underwent histological analysis that showed occlusion of the stent with granulation tissue (eight cases), necrotic material (four cases) and fibrosis (three cases).

Although encouraging in terms of safety, simplicity and reproducibility, the results obtained with the polyurethane stent demonstrate poor long-term efficacy and stimulate the search for new strategies such as programmed stent removal or the development of a more biocompatible material.