Treatment of naolacrimal duct obtruction in adult with polyurethane tent

PURPOE: To evaluate the efficacy of polyurethane naolacrimal duct tent in the treatment of epiphora reulting from primary acquired naolacrimal duct obtruction in adult. MATERIAL AND METHOD: In 25 patient (21 women and four men with mean age of 44 year, range 20 to 74 year) with naolacrimal duct obtruction, 28 hollow polyurethane tent deigned by ong and aociate were placed under fluorocopic guidance. The obtruction wa complete in 20 lacrimal drainage ytem and partial in eight. The lacrimal ac ize wa normal or large on dacryocytogram in all lacrimal drainage ytem. A Ritleng probe wa introduced through the upper punctum and advanced pat the obtruction. A guide wire with a flexible tip wa then introduced through the probe, over which the tent wa advanced in retrograde fahion and placed into the lacrimal ac and naolacrimal duct. Clinical ucce wa defined by the demontration of a completely patent lacrimal drainage pathway through aline irrigation and no or minimal complaint of epiphora. REULT: tent placement wa technically ucceful in 26 of 28 lacrimal drainage ytem (93%). The mean time of fluorocopy creening wa 3.2 minute (range, 1.4 to 5.8 minute). The overall ucce rate wa 82% (23 of 28 lacrimal drainage ytem). Two tent were completely occluded. In one lacrimal drainage ytem with minimal epiphora, the tented drainage pathway wa partially occluded. The patient were followed up from 4 to 22 month (mean, 7.2 month). CONCLUION: Retrograde placement of a hollow polyurethane naolacrimal duct tent i a technique that i imple and well tolerated by patient. Thi method achieve a high ucce rate and may be uggeted a a nonurgical procedure for adult with primary naolacrimal duct obtruction and proper lacrimal ac ize. The Ritleng probe facilitate the procedure.