The initial experience of using the drain implant to eliminate epiphora in patients with rhinogenous pathology

Abstract

The pathology of upper lacrimal pathways associated with cicatrical strictures and obliteration, anatomical features of this zone is an essential problem of epiphora occurrence. The diseases of nasal cavity and paranasal sinuses play a significant role in the etiopathogenesis of this kind of epiphora. The search of new methods of preventing or eliminating epiphora, also caused by rinological pathology, is reasonable.
 Aim: To estimate the efficacy of drainage implant HEALAFLOW (Aptissen, Switzerland) in patients with complains on epiphora and concomitant nasal cavity pathology.
 Material and methods. 29 patients (50 eyes) with complains on permanent (more than 6 months) epiphora were under the supervision. Ge nerally accepted ophthalmological, dacryological, rhinological examinations, including cone-ray computer tomography of the paranasal sinuses with preliminary contrast of the lacrimal pathways were carried out. Patients were divided into two groups. 15 people (28 eyes) composed the main group (I). 14 people (22 eyes) formed a control group (II). In I group the drainage implant HEALAFLOW (Aptissen, Switzerland) was inserted in 1 day after operation aimed on elimination of nasal cavity pathology. Patients of the II group instillation of Tobradex according to the scheme and moistening drops were prescribed.
 Results. According to dacryological examination 29 patients (50 eyes) with complains on epiphora had normal passive lacrimal pathway passablness, but delayed or negative results of probes characterizing active passablness. All 29 patients had a rhinological pathology, which was eliminated by the otorhinolaryngologist with the operation at the first stage. In I group 9 patients noticed an increased epiphora immediately after the administration of HEALAFLOW in lacrimal pathway, which lasted during the first 24 hours after the procedure. Based on the results of the follow-up examination, after 3 months, all patients showed an improvement, expressed in the absence or decrease of epiphora. It should be noted that in the I group (after the insertion of the implant) the positive effect was more expressed. In the I group 12 of 15 patients didn’t have epiphora and in 3 patients it decreased. In the II group — 7 patients didn’t have epiphora and in 6 patients it decreased.
 Conclusion. Insertion of drainage implant HEALAFLOW in the lacrimal pathway after elimination of rhinological pathology in patients with complains on epiphora is safe, well tolerated and produces a positive drainage effect. This allows to recommend the implant to patients with tear-off device abnormality in the complex treatment of tear outflow disorders.