Management of Adult Focal Nasolacrimal Duct Stenosis: Long-term Outcomes of 3D CT-DCG-assisted and Endoscopically-guided Coronary Catheter Balloon Dacryoplasty
Author: Izabela Nowak-Gospodarowicz
Base Hospital / Institution: Military Institute of Medicine-National Research Institute, Warsaw, Poland
Rapid fire oral presentation
Abstract ID: 24-418
Purpose
To evaluate the use of 3D CT-DCG-assissted and endoscopically-guided coronary catheter balloon dacryoplasty (CC-BDCP) in adults with focal stenosis of the nasolacrimal duct (NLD) and report their long-term outcomes.
Methods
A prospective non-randomized, single-center clinical study was performed over a two year period on all the patients with epiphora and a demonstrable focal stenosis of the nasolacrimal duct on 3D CT-DCG. The patients underwent endoscopy-guided CC-BDCP with the use of percutaneous transluminal coronary angioplasty (PTCA) balloon catheters. The success of the procedure was assessed at long-term, subjectively on the Munk’s scale and objectively by lacrimal drainage irrigation and fluorescein dye disappearance test (FDDT) at a 12-month follow-up. Statistical analysis was performed using the SPSS software.
Results
25 patients were enrolled in the study. The CC-BDCP procedure was performed in 21 of 25 (84%) patients and the remaining 4 (16%) patients had significant procedural difficulties due to unfavorable anatomical conditions. Of the 21 patients, 10 (47,6%) were procedurally assessed as “easy” (hereafter the eCC-BDCP group) and in 11 (52,4%) as procedurally “difficult” (the dCC-BDCP group). Values on Munk’s epiphora intensity scale changed overall from 4.0 preoperatively to 1.4±1.6 (p=000001) postoperatively (from 4.0 to 0.4±0.9 in the eCC-BDCP group and from 4.0 to 1.6±1.5 in the dCC-BDCP group (p=0.01596). FDDT changed overall from 2.9±0.3 to 1.1±1.2 after treatment (p=0.00008) (from 2.8±0.4 to 0.3±0.6 in the eCC-BDCP group and from 2.9±0.3 to 1.4±1.2 in the dCC-BDCP group (p=0.01352). The anatomical and functional success rate was 77% overall, 90% in the eCC-BDCP group, and 64% in the dCC-BDCP group.
Conclusion
Endoscopically assisted coronary balloon DCP led to a statistically significant decrease in epiphora in a particular group of adult patients with demonstrable focal stenosis of the NLD. The procedure may be technically challenging in a subset of patients with unfavorable anatomical conditions, which in turn can affect the procedure success.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Rafal | Nowak | Military Institute of Medicine-National Research Institute, Warsaw, Poland |
| Michal | Kinasz | Military Institute of Medicine-National Research Institute, Warsaw, Poland |
| Aleksandra Kinga | Kicinska | Military Institute of Medicine-National Research Institute, Warsaw, Poland |
| Marek | Rekas | Military Institute of Medicine-National Research Institute, Warsaw, Poland |
| Mohammad Javed | Ali | Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, India |
