Balloon Canaliculoplasty for Acquired Canalicular Stenosis

Abstract

Canalicular stenosis is a frequent cause of epiphora. Patients with canalicular stenosis often require timely insertion of bicanalicular silicone stents to prevent permanent and complete closure of the canaliculi. This study reports the use of balloon canaliculoplasty in conjunction with silicone tube intubation in selected cases of canalicular stenosis. Patients with canalicular stenosis noted upon probing of the upper and lower lacrimal systems were included in the study. Patients with punctal stenosis underwent concurrent punctoplasty. Patients with complete canalicular obstruction were excluded from the study. The procedure was as follows. Canalicular dilation was achieved with 2 successive dilations of 90 seconds with a 2-mm-diameter balloon dilator, followed by probing and intubation of the lacrimal system with bicanalicular Crawford tubes. Twenty-one eyes (41 canaliculi) of 12 patients (10 females, 2 males) with canalicular stenosis were included in this study. The average age was 64.5 ± 7.5 years. Silicone tubes were left in place for an average 5.5 ± 2.6 (range: 2 to 12) months. Mean follow up after tube removal was 6.2 ± 1.1 months. Improvement within 1 week of the procedure was recorded in 20 out of 21 canaliculi (95.2%). Final clinical outcomes were successful or acceptable in 16 out of 21 eyes (76.2%). Balloon canaliculoplasty with silicone tube intubation is simple and safe and appears to be an effective alternative treatment in patients with canalicular stenosis.