The purpose of this study was to evaluate, in a prospective, single-center study, the effectiveness of Song's
polyurethane stents, modified "in-house," in the percutaneous management of
epiphora. Patients (n = 170; age range 18-83, mean = 64; 50 male, 120 female) with severe
epiphora had the modified
stents inserted (183 eyes/195
stents) to treat unilateral/bilateral and complete/partial obstruction of the nasolacrimal system. The etiology of the obstruction was idiopathic in 119 cases (61%) and chronic
dacryocystitis in 76 (39%). The set designed by Song was used in all patients but modified by us such that the extreme end is cone-shaped. The original technique was slightly modified by us and the procedure was conducted on an outpatient basis. The initial technical success rate of
stent placement was 97%. Resolution of
epiphora was complete in 180 eyes and partial in 3. On follow-up (mean = 18 months; range: 2 days to 24 months), 165 of 195
stents (85%) remained patent. Primary patency rates at follow-up were 86%, 84%, 84%, and 79% in the first 6 months, second and third 6 months, and the present (24 months), respectively.
Stents became obstructed in 30 patients, but all but 2 were easily withdrawn and 20 of these patients remained asymptomatic for a mean of 14 months (secondary patency of 67%). Following
stent removal, the withdrawn
stent was replaced with a new
stent in the same intervention on 14 occasions. In another six cases, patency was re-established without the need of a second
stent. The procedure is simple and safe, both in
stent insertion as well as in mechanical de-blocking and withdrawal when occluded. Success was >80 % in the short term (1-year follow-up). Stenting failure does not preclude other treatment because with the modification that we had introduced, the extreme end of the
stent becomes more accessible to mechanical de-blocking, withdrawal, and relocation. The levels of primary and secondary patencies are promising and warrant more extensive investigation.