title: [Microendoscopic minimally invasive techniques in lacrimal surgery].
abstract: BACKGROUND
  Lacrimation of the eye is a relatively common problem, the cause of which must be clarified by differential diagnostics. The most important symptom of a dysfunction of lacrimal drainage is epiphora.
  
  
  METHODS
  Due to the enhancement and miniaturization of endoscopes, which were originally used in gastroduodenoscopy in the 1990s, it is possible to check the anatomical structure and visualize pathological changes of the lacrimal drainage system, which is only approximately 1 mm in diameter. As shown by the results, mechanical stenoses are often caused by recurrent chronic inflammation. A complete stenosis usually occurs only slowly due to dysregulation of the lacrimal unit.
  
  
  CONCLUSIONS
  In contrast to the assumptions that were valid before the implementation of microendoscopy, complete stenoses are often only punctate and do not stretch over long distances. Shortly after the introduction of microendoscopic diagnostics minimally invasive therapy techniques, such as laser dacryoplasty (LDP) and microdrill dacryoplasty (MDP) were established. These procedures have enabled for the first time preservation of the entire physiology of the lacrimal drainage pump system despite surgical intervention after recanalization.
authors.affiliation: Klinik für Augenheilkunde, Klinikum Darmstadt GmbH, Heidelberger Landstr. 379, 64297, Darmstadt, Deutschland. karl-heinz.emmerich@mail.klinikum-darmstadt.de.
authors.forename: K-H
authors.initials: KH
authors.lastname: Emmerich
authors.affiliation: Augenklinik der Universität Witten/Herdecke, St. Josefs-Hospital Hagen, Witten/Herdecke, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Amin
authors.affiliation: Augenklinik der Universität Witten/Herdecke, St. Josefs-Hospital Hagen, Witten/Herdecke, Deutschland.
authors.forename: H-W
authors.initials: HW
authors.lastname: Meyer-Rüsenberg
authors.affiliation: Klinik für Augenheilkunde, Klinikum Darmstadt GmbH, Heidelberger Landstr. 379, 64297, Darmstadt, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Ungerechts
mesh_terms: D003608:Dacryocystorhinostomy / Q000379:methods*; D003937:Diagnosis, Differential; D004724:Endoscopy / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000151:congenital / Q000175:diagnosis* / Q000628:therapy*; D008866:Microsurgery / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009887:Ophthalmoscopy / Q000379:methods*; D016896:Treatment Outcome
keywords: Dacryostenosis; Epiphora; Lacrimation; Laser dacryoplasty; Microdrill dacryoplasty