Modern lacrimal duct surgery from the ophthalmological perspective.
BACKGROUND
From the 1990's onward, it has been possible to assess changes in the lacrimal duct by direct, minimally invasive diagnostic inspection with the aid of miniaturized endoscopes originally used in gastroduodenal surgery. It has been shown in this way that mechanical lacrimal duct stenosis often develops gradually as the result of recurrent chronic inflammation. Absolute stenoses are often located at a single point rather than extending over a longer segment of the duct.


METHODS
Advances in lacrimal duct surgery are presented through a selective review of the relevant literature.


RESULTS
Roughly 70% to 80% of all mechanical stenoses of the lacrimal duct can be reopened during endoscopic surgery with the use of a laser or a miniaturized drill.


CONCLUSIONS
With the methods described here, it is now possible for the first time to perform surgery that obviates the need for a bypass procedure and maintains or restores the normal physiological function of the lacrimal system.
Meyer-Rüsenberg
Hans-Werner
HW
Augenklinik, Katholisches Krankenhaus gem. GmbH Hagen, Universität Witten/Herdecke. meyer-ruesenberg@kkh-hagen.de
Emmerich
Karl-Heinz
KH
D003608:Dacryocystorhinostomy / Q000379:methods*; D003952:Diagnostic Imaging; D004724:Endoscopy / Q000379:methods; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000209:etiology; D007767:Lacrimal Duct Obstruction / Q000175:diagnosis; D008866:Microsurgery / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000379:methods