Therapy of Postsaccal Occlusions by Dacryocystoplasty or Stent Implantation
Grob M.1, Lachmund U.2, Forrer A.3, Petralli C.2
1Vista Klinik, Binningen, Switzerland; 2Department of Radiology, Kantonsspital Bruderholz, Switzerland; 3Department of Ophthalmology, Kantonsspital Aarau, Switzerland
Purpose: To examine the clinical outcome of the dacryocystoplasty (DCP) or stent implantation in postsaccal occlusion.
Method: Between 01.03.1999 and 26.3.2003 11 patients with epiphora and proven obstruction of the canaliculus communis by dacryocystography (DCG) were treated with balloon dilatation or stent implantation in local anaesthesia. 3/11 patients had a short, 8 patients had a long postsaccal occlusion. A stent implantation was performed in long occlusions only.
Results: In 9/11 patients the DCP was successful, in 2 cases it came to an epistaxis. The 3/9 short occlusions were treated with DCP only, 2/3 successfully. In 5/8 long occlusions a DCP was performed initially. 3/5 of these cases showed a spontaneous re-occlusion. A stent implantation followed in 3/4 patients with DCP and in one patient without DCP. In 2/4 cases only the Cook stent, in 1/4 the Cook and Wilhelm stent, in one patient only the Wilhelm stent was implanted. The Cook stent made in 1/5 a spontaneous re-occlusion after 2 weeks, a second Cook stent had to be flushed after 1 year and remained open until now. The Wilhelm stent is easy to implant and does not re-occlude. After ½ year follow-up there are no re-occlusions. In sh
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