[Nasolacrimal stent implantation: report of a case].

Arq Bras Oftalmol

Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.

Published: January 2009

AI Article Synopsis

  • Epiphora, or excessive tearing, often results from blocked tear drainage, commonly due to idiopathic inflammation of the nasolacrimal duct.
  • A case in Brazil involved a less invasive nasolacrimal stent implantation that ultimately required follow-up surgery (external dacryocystorhinostomy) after patient complaints persisted.
  • While the stent method minimizes facial scarring and trauma, its long-term effectiveness is low, indicating a need for better designs and techniques to improve outcomes.

Article Abstract

Epiphora (watering eye) is generally caused by insufficient drainage of tears. The most common cause of epiphora in adults is idiopathic inflammatory obstruction of the nasolacrimal duct. The traditional surgical treatment of nasolacrimal duct obstruction is an external dacryocystorhinostomy, which has an 85% to 95% success rate. To eliminate cutaneus wounds and scarring some techniques were introduced, for example the endonasal laser dacryocystorhinostomy and the nasolacrimal stent. The aim of this report was to evaluate the first case of nasolacrimal stent implantation in Brazil. The procedure was performed in the "Hospital das Clínicas" of the University of São Paulo - USP. A female patient with tearing of the right eye and secretion was submitted to a nasolacrimal stent implantation, with fluoroscopic guidance. The stent used in this procedure was the polyurethane Tearleader stent set. (Dr. Wilhelm type-PBN MEDICALS - Denmark). After 3 months, the patient started complaining of tearing, so the stent was removed and the patient was submitted to an external dacryocystorhinostomy. At present the patient does not have any symptoms or complaints. This procedure is less invasive and simple, causes no facial scars and avoids surgical trauma, but the long term success rates achieved using polyurethane nasolacrimal stents are low as compared with the external dacryocystorhinostomy. In addition, the patients usually complaint of tearing even having patent lacrimal system. In summary, long-term studies are needed to resolve some complications. Maybe a new stent design and new methods of unblocking the stent in situ would improve in the near future the levels of patency that currently are modest.

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Source
http://dx.doi.org/10.1590/s0004-27492008000100024DOI Listing

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