Use of the Masterka for complex nasolacrimal duct obstruction in children.

Background: The Masterka stent has been recommended solely for treatment of simple distal membranous nasolacrimal duct obstruction (NLDO). The purpose of this study was to evaluate the Masterka stent as a primary treatment in complex forms of NLDO, including bony ductal stenosis and proximal and serial membranous obstruction.

Methods: The medical records of patients who underwent treatment for congenital nasolacrimal duct obstruction with the monocanalicular Masterka stent were reviewed retrospectively. Both simple and complex forms of NLDO were primarily treated with probing and irrigation, followed by placement of the Masterka stent.

Results: A total of 72 eyes (53 patients) were included: 17 cases were simple forms of NLDO; and 55 were complex. Success was achieved in 15 of 17 simple cases (88%) and 39 of 55 complex cases (71%); the overall success rate was 75%. In patients <24 months of age, success rates were 100% for simple and 78% for complex forms.

Conclusions: The Masterka stent can be useful in a younger subset of patients with more complex forms of congenital NLDO. A lower success rate is noted in children >2 years of age and complex forms of NLDO, especially those with bony stenosis.