Lacrimal system obstruction treated with lacrimal polyurethane stents: Outcome of removal of occluded stents

PURPOSE: To describe the short- and long-term outcomes of the removal of occluded stents. MATERIALS AND METHODS: With fluoroscopic guidance, 571 lacrimal polyurethane stents were placed in 502 patients with epiphora due to obstruction of the lacrimal system. Of the 571 stents, 142 were removed 2 weeks to 42 months (mean, 7 months) after placement because of recurrent epiphora, and the lacrimal system was irrigated with saline solution through the lacrimal point. RESULTS: Stent removal was well tolerated. Mild epistaxis occurred in one patient and was controlled with a nasal pack. Recurrent epiphora was due to obstruction of the stent with mucoid material in 49 (35%) of 142 systems and granulation tissue in 93 (65%) systems. After stent removal, 73 (51% of the 142 lacrimal systems showed improvement of epiphora, with a patent lacrimal system at 7-day follow-up dacryocystography. During the follow-up of 2 weeks to 49 months (mean, 22 months) after stent removal, patency was maintained in 24 (33%) of the 73 lacrimal systems. CONCLUSION: Removal of an occluded lacrimal plastic stent was easy and safe. Recurrent epiphora effect placement of lacrimal plastic stents can be treated with removal of the occluded stents and irrigation with saline solution through the lacrimal point, which resulted in a patent lacrimal system in 33% of cases in this study.