Randomized comparison of nasolacrimal cryoplasty versus plastic lacrimal stenting in the management of epiphora in adults.

Abstract

PURPOSE:

To evaluate the efficacy of plastic polyurethane stents compared with nasolacrimal cryoplasty in the management of epiphora in adults.

MATERIALS AND METHODS:

Patients (N = 37; mean age, 64 years; range, 34-86 y; six men, 31 women) with severe epiphora with partial/complete obstruction of the nasolacrimal system were randomized to have a plastic stent inserted (n = 19) or to undergo balloon dilation cryoplasty (n = 18). Both procedures were conducted on an outpatient basis. Patency was assessed with Kaplan-Meier curves.

RESULTS:

Initial technical success rate and immediate resolution of epiphora was complete in all cases. At 6 months of follow-up, outcomes were already significantly different between the treatment groups and hence the study was discontinued. Plastic stent placement achieved a primary patency rate of 59.6% at 6 months, compared with 12.4% in the cryoplasty group (P < .0004). Multivariate analysis indicated that other measured variables (sex, age, etiology, previous treatment, and the interventional radiologist's expertise) had no significant effect on the outcomes (P > .05).

CONCLUSIONS:

Initial success was good in both treatment groups, with nasolacrimal plastic stent placement achieving a level of primary patency superior to the cryoplasty procedure for the relief of epiphora on short-term follow-up. However, long-term outcome evaluation is needed before stent placement can be recommended as an alternative to more established surgical procedures.

• Authors: Carlos Lanciego, Sofía Navarro, Javier Velasco, Miguel Perea, Rafael Cuena-Boy, Lorenzo García-García
• Journal: Journal of vascular and interventional radiology : JVIR (J Vasc Interv Radiol) Vol. 20 Issue 12 Pg. 1588-96 (Dec 2009) ISSN: 1535-7732 [Electronic] United States
• PMID: 19944984 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Polyurethanes

Topics

• Adult
• Aged
• Aged, 80 and over
• Ambulatory Care
• Catheterization (adverse effects, instrumentation)
• Female
• Humans
• Kaplan-Meier Estimate
• Lacrimal Apparatus Diseases (diagnostic imaging, therapy)
• Male
• Middle Aged
• Polyurethanes
• Prosthesis Design
• Radiography, Interventional
• Stents
• Time Factors
• Treatment Outcome