gms | German Medical Science

Epiphora is a common ophthalmologic problem, comprising 3% of clinical visits. It results from either overproduction or impaired drainage of lacrimal fluid, because of stenosis / obstructions of tear ducts. In most patients the symptomatic is caused by stenosis or complete obstruction of the nasolacrimal duct system. The most common site of obstruction is the junction of the saccus and nasolacrimal duct. While in the past, treatment of this condition was surgical (e.g. by dacryocysto-rhinostomy) , interventional procedures have been developed and have become well established for treatment in selected cases. To identify patients suitable for interventional therapy, the exact cause for epiphora has to be determined.

Fluoroscopically guided dacryocystoplasty is a feasible nonsurgical therapy in nasolacrimal duct obstructions with good clinical results that may be used as an alternative to surgical procedures. Dacryocystoplasty is performed on an outpatient basis in local anaethesia, the normal anatomy is respected and no scarring results. In stenosis the results of balloondilatation are comparable with these of surgical procedures. In patients with complete obstructions stent placement is possible but further modifications are in progress to improve long-term results.