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Guillermo Salcedo, Brian Willoughby, Hugo Quiroz-Mercado, Ariel Ceriotto, Ania Buigues; Para-nasal Sinus Lacrimal Diversion in Patients with Epiphora Resulting from Complete Canalicular Obstruction and/or functional epiphora in the setting of a patent lacrimal system with a new stent. Invest. Ophthalmol. Vis. Sci. 2013;54(15):739.
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The DCS Lacrimal Stent is a flexible silicone stent which has been optimized for both improved anchoring and comfort and offers a minimally invasive approach intended for treatment conditions which requires lacrimal bypass by creating an indwelling fistula between the lacrimal apparatus/conjunctiva and the ethmoid sinus for the treatment of epiphora. The purpose of this study is to asess the safety, tolerance, and efficacy of the DCS Lacrimal Stent via the paranasal sinus route in patients with epiphora resulting from complete canalicular obstruction and/or functional epiphora in the setting of a patent lacrimal system.
After twenty cadaver lacrimal/sinus procedures have been performed, eligible patients who have signed an informed consent was sent to CT scan and underwent placement of the DCS Lacrimal Stent by an experienced Oculoplastic or ENT surgeon as an outpatient procedure. The DCS Lacrimal Stent remained in place for 6 months or until one or more of the criteria for removal were present. 16 stents in 13 patients has been placed, with an age range of 22-79 years.
At 90 days It was found passive permeability of 60% and active permeability of 75%.Subjective improvement was greater than 70% in 10 of 16 eyes. before 90 days 4 stents were removed, 3 due for bad position and 1 for intolerance. Adverse effects were mild (conjunctivitis n=4, carunculitis n=1, blepharokeratitis n=1, hematoma n=1), moderate (keratoconjunctivitis sicca n=1, pain n=1) and severe (lid retraction n=1, cephalea n=1)
Functional results at the moment are satisfactory and safe in most of cases . It is required preoperative CT- Scan to determine the angle of placement. The mayority of stents stayed at the implantation site. Surgical time was less than 30 minutes as an outpatient procedure . The DCS Lacrimal Stent placed from conjunctiva to etmoid sinus sems to be a safe and easy alternative for epiphora resulting from complete canalicular obstruction.
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