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Balloon Catheter Dilation in Common Canalicular Obstruction of the Lacrimal System: Safety and Long-term Effectiveness¹

¹ From the Department of Diagnostic Radiology, Kangnam St Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul (G.Y.K.), and the Departments of Diagnostic Radiology (D.H.L., H.K.Y., K.B.S., H.Y.S.) and Ophthalmology (H.S.A.), Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-dong, Songpa-ku, Seoul 138-736, Korea. From the 1997 RSNA scientific assembly. Received April 27, 1998; revision requested July 6; final revision received June 9, 1999; accepted August 18. Address reprint requests to H.Y.S. (e-mail: hysong@www.amc.seoul.kr).

PURPOSE: To evaluate the safety and long-term effectiveness of balloon catheter dilation in the treatment of common canalicular obstruction of the lacrimal system.

MATERIALS AND METHODS: Fluoroscopically guided dilation with a 3-mm-diameter balloon catheter was attempted in 195 eyes of 148 patients (26 men, 122 women; mean age, 57 years; age range, 33–78 years) with epiphora due to common canalicular obstruction. Eighty-four of 195 eyes had complete obstruction, and 111 had partial obstruction.

RESULTS: Complications were self-limited nasal bleeding (n = 8), false passage (n = 7), and extravasation of contrast material (n = 6). Initial technical success was achieved in 76 (90%) of 84 eyes with complete obstruction and in 104 (94%) of 111 eyes with partial obstruction. In the 180 eyes with technical success, immediate clinical improvement was achieved in 76 eyes with complete obstruction and in 100 eyes with partial obstruction. The mean follow-up period was 36 weeks (range, 4–168 weeks). The cumulative patency rates were 51% at 6-month, 43% at 12-month, and 40% at 24-month follow-up.

CONCLUSION: Although the long-term recurrence rate is relatively high, balloon catheter dilation is a safe and effective therapeutic technique to be used initially in common canalicular obstruction.

Index terms: Eye, diseases, 223.20, 223.49 • Lacrimal gland and duct, interventional procedures, 223.1269 • Lacrimal gland and duct, radiography, 223.1295

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