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Transcanalicular THC:YAG dacryocystorhinostomy.
R Z Silkiss1, R N Axelrod, A G Iwach
1Summit Medical Center, Oakland, Calif.
Ophthalmic Surgery
|May 1, 1992
Summary
This study demonstrates a novel laser technique using chromium-sensitized, thulium- and holmium-doped YAG lasers (THC:YAG laser) to create nasal bony ostia for dacryocystorhinostomy. The method shows potential for simplifying surgical procedures.
Area of Science:
- Ophthalmology
- Otolaryngology
- Laser Surgery
Background:
- Dacryocystorhinostomy (DCR) is a surgical procedure to restore tear drainage.
- Conventional DCR techniques can be complex and time-consuming.
- Endonasal laser DCR offers an alternative but may have limitations.
Purpose of the Study:
- To evaluate the efficacy of a novel THC:YAG laser system for creating a nasal bony ostium.
- To assess the feasibility of using this laser technique in dacryocystorhinostomy procedures.
Main Methods:
- Utilized chromium-sensitized, thulium- and holmium-doped YAG lasers (THC:YAG laser) operating at 2.1 microns.
- Created nasal bony ostia in human cadaver heads by passing a 320-micrometer laser fiber through the lacrimal sac fossa.
- Employed long-pulsed laser settings (300 ms) with pulse energies of 250-900 mJ and repetition rates of 5-15 Hz.
Main Results:
- Achieved full-thickness bony ostia, approximately 3-4 mm in diameter, using energy levels of 1.25-9 W.
- Successfully threaded silicone tubing through the canalicular system post-ostium creation.
- Demonstrated a consistent and effective method for ostium formation.
Conclusions:
- The THC:YAG laser technique provides a viable method for creating nasal bony ostia.
- This laser-assisted approach may simplify both conventional and endonasal laser dacryocystorhinostomy.
- Further research is warranted to clinically validate this promising surgical technique.