Obstructed nasolacrimal duct system in epiphora: Long-term results of dacryocystoplasty by means of balloon dilation

PURPOSE: To evaluate the longterm results of balloon dacryocystoplasty in the treatment of epiphora due to obstruction of the nasolacrimal ducts. MATERIALS AND METHODS: One hundred eyes in 84 patients with complete or incomplete obstruction of the lacrimal sac and duet were selected for dacryocystoplasty. A catheter with a balloon diameter of 3 mm was used. Follow-up was 5-48 months. No stents were placed. A Kaplan-Meier analysis was used to evaluate patency. RESULTS: The long-term primary pateney rate was 70% +/- 7 (+/- standard error). Repeat dacryocystoplasty was successful in 10 of the 11 cases with initial failure or reobstruction during follow-up, which yielded a long-term secondary patency rate of 81% +/- 7. There was no association between the length of the obstruction or the duration of symptoms before dacryocystoplasty and the initial and long-term success. Initial and long-term success was statistically significantly higher in dacryocystoplasty for an incomplete obstruction rather than for a complete obstruction. CONCLUSION: The long-term results of dacryocystoplasty, followed if necessary by repeat dacryocystoplasty, are good. Dacryocystoplasty is a safe and simple procedure and could become the treatment of choice for epiphora due to obstruction of the nasolacrimal ducts. Dacryocystorhinostomy is indicated when dacryocystoplasty or repeat dacryocystoplasty fails or when dacryocystoplasty is contraindicated (eg, in anatomic malformations in the lacrimal duct or bony canal).