Long-term Outcome of Nasolacrimal Duct Obstruction Treated with Nasolacrimal Polyurethane Stents (Song's Stent)

Kyung-Won Suk; Sang-Soo Kim

doi:10.3341/jkos.2008.49.8.1209

Journal List > J Korean Ophthalmol Soc > v.49(8) > 1008037

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Suk and Kim: Long-term Outcome of Nasolacrimal Duct Obstruction Treated with Nasolacrimal Polyurethane Stents (Song's Stent)

Original Article

J Korean Ophthalmol Soc 2008;49(8):1209-1214.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.8.1209

Long-term Outcome of Nasolacrimal Duct Obstruction Treated with Nasolacrimal Polyurethane Stents (Song's Stent)

Kyung-Won Suk, M.D., Sang-Soo Kim, M.D.

Department of Ophthalmology, Maryknoll Hospital, Pusan, Korea

Address reprint requests to Sang-Soo Kim, M.D.Department of Ophthalmology, Maryknoll Hospital #4ga-12 Daechung-dong, Jung-gu, Pusan 600-730, Korea Tel: 82-51-461-2549, Fax: 82-51-462-3534, E-mail: eyerheu@hanafos.com

Received 23 April 2008 Accepted 14 January 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was carried out to evaluate and investigate the long-term outcome of placement of 25 plastic nasolacrimal stents (Song's stents) without fluoroscopic guidance for the treatment of obstructed nasolacrimal ducts.

Methods

The medical records of 25 patients who had had Song’s polyurethane stents placed between 1997 and 2003 were reviewed. The patients included 17 women and 8 men who ranged in age from 22 to 79 years (mean, 57.9 years). The mean follow-up period was 54 months.

Results

The overall technical success in this study was 92% (23 of 25 eyes), with a 91% (21 of 23 eyes) short-term success rate. Of the 21 stents deployed, at the end of this study, 20 stents (95%) had been occluded. The median duration of stent patency was 38 months. The interquartile range of stent patency (75%∼25%) were 26 and 50 months, respectively.

Conclusions

Although nasolacrimal stenting with Song's stents is a relatively simple and safe procedure and is a useful alternative in elderly patients or patients in poor general condition, nasolacrimal stenting with Song’s stents does not meet the requirement of long-term efficacy for epiphora resolution.

Keywords: Nasolacrimal duct obstruction, Nasolacrimal stent, Song's stent, Stent patency

References

1. Munk PL, Lin DT, Morris DC. Epiphora; treatment by means of dacryocystoplasty with ballon dilatation of the nasolacrimal drainage apparatus. Radiology. 1990; 177:687–90.

2. Sohn HY, Hur J, Chung EH, Won IG. Clinical Observation on Silicone Intubation in Obstruction of Lacrimal Drainage System. J Korean Ophthalmol Soc. 1990; 31:135–40.

3. Song HY, Jin YH, Kim JH. . Nasolacrimal duct obstruction treated nonsurgically with use of plastic stents. Radiology. 1994; 190:535–9.

4. Kim BO, Jin KH, Oh JH. Clinical observation on nasolacrimal duct stent intubation in obstruction of nasolacrimal system. J Korean Ophthalmol Soc. 1995; 36:994–9.

5. Lee JS, Jeong G, Lee SH. . Treatment of obstructed nasolacrimal duct by lacrimal stent without fluoroscopic guidance. J Korean Ophthalmol Soc. 1996; 37:2125–31.

6. Toti A. Nuovo metodo conservatore di cura radicale delle suppuraxioni croniche del sacco lacrimale(Dacriocistorinostomia). Clin Mod Firenze. 1904; 10:385–7.

7. Hausler R, Caversaccio M. Microsurgical endonasal dacryocy- storhinostomy with long-term insertion of bicanalicular silicone tubes. Arch Otolaryngo Head Neck Surg. 1998; 124:188–91.

8. Neuhaus RW. Orbital complications secondary to endoscopic sinus surgery. Ophthalmology. 1990; 97:1512–8.

9. Cunningham MJ, Woog JJ. Endonasal endoscopic dacryocy- storhinostomy in children. Arch Otolaryngol Head Neck Surg. 1998; 124:328–33.

10. Woog JJ, Metson M, Puliafito CA. Holmium: YAG endonasal laser dacryocystorhinostomy. Am J Ophthalmol. 1993; 116:1–10.

11. Boush GA, Lemke BN, Dortzbach RK. Results of endonasal laser assisted dacryocystorhinostomy. Ophthalmology. 1994; 101:955–9.

12. Kong YT, Kim TI, Kong BW. A report of 131 cases of endoscopic laser lacrimal surgery. Ophthalmology. 1994; 111:152–7.

13. Lee SH, Chung WS. Long Term Surgical Efficacy of Endonasal Dacryocystorhinostomy. J Korean Ophthalmol Soc. 2000; 41:307–13.

14. Rice DH. Endoscopic intranasal dacryocystorhinostomy results in four patients. Arch Otolaryngol Head Neck Surg. 1990; 116:1061.

15. Song HY, Ahn HS, Park CK. . Complete obstruction of the nasolacrimal system. Part I: treatment with balloon dilation. Radiology. 1993; 186:367–71.

16. Lee JM, Song HY, Han YM. . Balloon dacryocystoplasty: results in the treatment of complete and partial obstruction of the nasolacrimal system. Radiology. 1994; 192:503–8.

17. Wright KC, Wallace S, Charnsangavej C. . Percutaneous endovascular stents; an experimental evaluation. Radiology. 1985; 156:69–72.

18. Lee JS, Jung G, Oum BS. . Clinical efficacy of the polyurethane stent without fluoroscopic guidance in the treatment of nasolacrimal duct obstruction. Ophthalmology. 2000; 107:1666–70.

19. Yazici B, Yazici Z, Parlak M. Treatment of nasolacrimal duct obstruction in adults with polyurethane stent. Am J Ophthalmol. 2001; 131:37–43.

20. Ozturk S, Konuk O, Ilgit ET. . Outcome of patients with nasolacrimal polyurethane stent implantation: do they keep tearing? Ophthal Plast Reconstr Surg. 2004; 20:130–5.

21. Kang SG, Song HY, Lee DH. . Nonsurgically placed nasolacrimal stents for epiphora: long-term results and factors favoring stent patency. J Vasc Interv Radiol. 2002; 13:293–300.

22. Lee JH, Kang MS, Yang JW. Clinicopathologic findings after nasolacrimal polyurethane stent implantations. Korean J Ophthalmol. 2005; 19:252–7.

Figure 1.

Song's nasolacrimal duct stent set. a. Ball guide wire (W); b. Stent kit=Teflon sheath (T), Lacrimal stent (L), Pusher catheter (P); c. Lacrimal hook (H)

Figure 2.

Kaplan-Meier curve shows the cumulative stent patency rate. (median, 38 months; interquartile range, 26∼50 months)

Figure 3.

Brownish precipitates in polyurethane nasolacrimal stent lumen are shown.

Table 1.

Data for 25 patients with nasolacrimal obstruction

Age/Sex	Symptom duration	Cause	Technical success*	Short-term success^†	Follow-up (mo)	Duration of stent patency (mo)
74/M	15 y	idiopathic	yes	yes	28	25
67/F	5 y	idiopathic	yes	yes	19	15
48/M	7 y	trauma	yes	no	-	-
74/F	10 y	idiopathic	yes	yes	50	38
78/F	21 y	idiopathic	yes	yes	40	39
54/F	4 y	idiopathic	yes	yes	28	26
64/F	7 y	idiopathic	yes	yes	46	40
62/F	5 y	idiopathic	yes	yes	60	50
57/M	3 y	idiopathic	yes	yes	68	67
44/F	14 y	idiopathic	no	-	-	-
52/M	3 y	idiopathic	yes	yes	47	34
79/F	2 y	idiopathic	yes	yes	37	35
28/F	8 mo	idiopathic	yes	no	-	-
60/M	9 y	idiopathic	yes	yes	39	38
60/F	1 y	trauma	yes	yes	29	23
23/F	10 y	idiopathic	yes	yes	69	61
44/F	5 y	idiopathic	yes	yes	36	26
59/F	5 y	idiopathic	yes	yes	81	80
62/M	12 y	idiopathic	yes	yes	64	59
62/M	12 y	idiopathic	yes	yes	42	40
45/F	1 y	idiopathic	yes	yes	33	30
67/F	3 y	idiopathic	yes	yes	19	18
68/M	7 y	idiopathic	yes	yes	57	55
58/F	4 y	idiopathic	yes	yes	29	26
22/F	6 mo	trauma	no	-	-	-

^* Technical success=Grade 0-1 on Munk’s scale for initial 1 week;

^† Short-term success=Grade 0-1 on Munk's scale for 6 months.

TOOLS

Similar articles