Comparative analysis of the results of balloon dacryoplasty for stenoses at different levels of the vertical portion of lacrimal pathways

Abstract

AIM: to compare the effectiveness of balloon dacryoplasty (DCP) for stenoses at different levels of the vertical portion of lacrimal pathways and to establish the necessity of consequent intubation. MATERIAL AND METHODS: A total of 120 clinical cases in 85 patients (66 females and 19 males with the mean age of 53.61 ± 11.82 years) have been analyzed. Patients with cervical stenosis of the lacrimal sac constituted two groups: group 1 (19 patients, 30 balloon DCP surgeries) and group 2 (22 patients, 30 balloon DCP surgeries with Ritleng intubation). Two other groups consisted of patients with nasolacrimal orifice stenosis: group 3 (21 patients, 30 balloon DCP surgeries) and group 4 (23 patients, 30 balloon DCP surgeries with Ritleng intubation). Besides routine examinations, the assessment included collection of Munk's scores for epiphora, evaluation of health-related quality of life, lacrimal meniscometry, lacrimal scintigraphy, contrast enhanced multi-slice spiral computed tomography of lacrimal pathways, and single-photon emission computed tomography. The follow-up period was 6 months. RESULTS: In group 1 a complete recovery was achieved in 18 (60.00%) cases, improvement--in 9 (30.00%) cases, while a relapse occurred in 3 (3.00%) cases; in group 2, there were 18 (60.00%) recoveries, 10 (33.33%) improvements, and 2 (6.67%) relapses; in group 3--12 (40.00%) recoveries, 5 (16.66%) improvements, and 13 (43.34%) relapses; in group 4--19 (63.33%) recoveries, 8 (26.67%) improvements, and 3 (10.00%) relapses. CONCLUSION: Balloon dacryoplasty is effective in restoring patency of occluded lacrimal pathways. Success rate is higher in cervical stenoses of the lacrimal sac than in nasolacrimal orifice stenoses. Ritleng intubation after balloon DCP favors better outcomes in patients with nasolacrimal orifice stenosis.