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Intralacrimal migration of Masterka® stents
B Fayet1, E Racy2, W R Katowitz3
1Ophthalmology Department, hôpitaux universitaires Paris Centre, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Ophthalmology Department, University Hospital Necker-Enfants malades, AP-HP, Paris V René Descartes University, 149, rue de Sèvres, 75015 Paris, France.
Journal Francais D'Ophtalmologie
|March 27, 2018
Summary
Intralacrimal migration of self-retaining stents, like Masterka®, can occur in nasolacrimal duct obstruction cases. Careful surgical technique and monitoring are crucial for prevention and management.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Congenital nasolacrimal duct obstruction is common in children, often treated with silicone stents.
- Masterka® is a type of self-retaining stent used for this condition, similar to Monoka®.
- Surgical complications, including intralacrimal migration, can occur with these devices.
Observation:
- Two pediatric cases of Masterka® stent intralacrimal migration after nasolacrimal duct obstruction surgery were analyzed.
- Stent disappearance occurred at 7 days and 2 years post-implantation in the two patients.
- One stent fully migrated and externalized through the nose; the other was retrieved via a canalicular approach.
Findings:
- Self-retaining stent disappearance is estimated at 15%, with intralacrimal migration in 0.5% of these cases.
- Successful management of intralacrimal migration was achieved in both reported cases, with no further epiphora.
- Prevention hinges on meticulous surgical technique and post-operative monitoring.
Implications:
- Rigorous surgical technique, focusing on the stent's meatus and fixation head, is vital to prevent migration.
- Scheduled monitoring post-lacrimal intubation is necessary to detect stent disappearance.
- Management strategies include clinical assessment, rhinoscopy, and potentially exploratory canaliculotomy.
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