Transcanalicular laser-assisted dacryocystorhinostomy.
OBJECTIVE
Current techniques of laser-assisted dacryocystorhinostomy are mostly endonasal. In this report, the authors describe their technique of laser-assisted dacryocystorhinostomy performed through the canaliculi and the surgical results they achieved.


METHODS
Fourteen patients with nasolacrimal duct obstruction underwent transcanalicular laser-assisted dacryocystorhinostomy. The bony ostium was perforated using a fiber optic-transmitting, giant-pulse Nd:YAG laser, with an energy of 0.5 to 4 J per pulse. The total energy used to create an ostium was 18 to 34 J. A silicone tube was inserted through the canaliculi and the ostium into the nasal cavity and kept in place for 5 to 7 months. Patients were observed for 18 to 22 months.


RESULTS
Nine of the 14 patients (64%) reported the disappearance of epiphora following surgery. In 3 patients, no relief of epiphora was obtained. In 1 patient the operation was not completed because of severe nasal bleeding. In another, tearing began 12 months after surgery (6 months after tube removal).


CONCLUSIONS
Transcanalicular laser-assisted dacryocystorhinostomy is a potentially useful method for performing dacryocystorhinostomy. Technical modifications and improvements are needed to increase the success rate.
Rosen
N
N
Goldschleger Eye Institute, Sackler School of Medicine, Tel Aviv University, Sheba Medical Center, Tel Hashomer, Israel.
Barak
A
A
Rosner
M
M
D000368:Aged; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery*; D009666:Nose; D019106:Postoperative Hemorrhage / Q000601:surgery; D019919:Prosthesis Implantation; D012086:Reoperation; D012826:Silicone Elastomers; D017211:Treatment Failure
D012826:Silicone Elastomers