Balloon catheter dilatation of common canaliculus stenoses.

OBJECTIVE To determine the efficacy of balloon catheter dacryocystoplasty in treating stenoses of the common canaliculus. MATERIALS AND METHODS Between 1997 and 2004, elective balloon catheter dilatation was performed under local anesthesia in 36 patients with epiphora and dacryocystography (DCG)-proven high-grade stenosis of the common canaliculus. Eight of the 36 patients had additional stenosis of the nasolacrimal duct. A 2.5-mm diameter balloon was used for common canaliculus obstructions, a 3-mm balloon for nasolacrimal duct obstructions. RESULTS Dilatation was technically successful in 34/36 patients. In 2/36 patients the guide wire could not be advanced beyond the obstruction. There were no complications. During a mean follow-up of 9 months restenosis occurred in 4/36 patients, in one of whom it led to occlusion of the common canaliculus; a chronic dacryocystitis had already resulted in occlusion of the common canaliculus in this patient's other eye. Two of four restenoses were successfully dilated in a second procedure. In one patient, a bilateral presaccal occlusion was suspected clinically. DCG revealed a high-grade common canaliculus stenosis in both eyes. After balloon catheter dilatation the patient was complaint free in one eye, and in the other eye symptoms improved. CONCLUSIONS The therapy of choice for common canaliculus stenoses in addition to canaliculodacryocystorhinostomy is silicone tube implantation. The results of both procedures, however, are often disappointing. Balloon catheter dilatation is a minimally invasive technique carried out under local anesthesia which represents an alternative therapy option for the treatment of stenoses of the common canaliculus.