Balloon Dacryocystoplasty with Pushed Monocanalicular Intubation as a Primary Management for Primary Acquired Nasolacrimal Duct Obstruction

Though dacryocystorhinostomy (DCR) has long served as the gold treatment for primary nasolacrimal duct obstruction (PANDO), balloon dacryocystoplasty (DCP) and silicone stent intubation were applied especially in partial PANDO in the attempts to avoid osteotomy and reduce invasiveness. Herein, we present the results of the combined procedures with balloon DCP and pushed monocanalicular intubation in complete PANDO, and comparison of the combination to balloon DCP alone. We retrospectively reviewed 72 eyes of 56 patients, including 37 eyes of 29 patients in the combination group and 35 eyes of 28 patients in the balloon DCP alone group. There was no significant difference in the success rate between antegrade balloon DCP with and without pushed MCI in general. Nevertheless, interestingly the former procedure was associated with significantly higher surgical success rate than the latter in younger patients.

Application Possibilities of a New Preloaded Nasolacrimal Duct Intubation System

Introduction The LacriJet (FCI S. A. S. – France Chirurgie Instrumentation, Paris, France) represents a novel, simplified and preloaded system for monocanalicular or monocanaliculonasal nasolacrimal duct intubation. It is a further development of the Masterka and shall reduce the intubation time during the surgical procedure. The aim of the present study was to present first experiences with this system for different indications. Material and Methods All patients who underwent nasolacrimal duct intubation with the LacriJet at the University of Muenster Medical Center in the period from March to November 2019 were included. The postoperative outcome was evaluated 3 to 6 months later. Results In total, 12 nasolacrimal duct intubations with the LacriJet were performed at our center in the above-mentioned period. The main indication for intubation was congenital nasolacrimal duct obstruction (CNLDO). In addition, intubation was performed in cases with eye lid tumors involving the nasolacrimal duct, in a case of canalicular laceration and in a case of canaliculitis. In 3 cases, there was an early dislocation or a complete loss of intubation. Of these, 2 were cases with CNLDO and the third dislocation was due to manipulation by the patient. All in all, the functional results were satisfying. Summary The use of the LacriJet is highly suitable for the treatment of CNLDO, stenting in canalicular laceration or lid tumours involving the lacrimal drainage system. However, the known disadvantages of monocanalicular intubation (dislocation, early loss of intubation) also occur with this type of system and a system briefing seems useful. The LacriJet therefore represents a modern and simple method for nasolacrimal duct intubation and can be used for various indications.