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Related Experiment Video

Updated: May 13, 2026

A Novel Technique of Rescuing Capsulorhexis Radial Tear-out using a Cystotome
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Virtual Reality and Mixed Reality-Assisted Endoscopic DCR in Extremely Complex Lacrimal Obstructions.

Rafal Nowak1,2, Izabela Nowak-Gospodarowicz1, Marek Rękas1

  • 1Department of Ophthalmology, Military Institute of Medicine-National Research Institute, Warsaw, Poland.

The Laryngoscope
|March 21, 2024
PubMed
Summary

Virtual reality (VR) and mixed reality (MR) enhance endoscopic dacryocystorhinostomy (DCR) for complex blockages. These technologies aid in planning and executing challenging surgeries for congenital or acquired nasolacrimal duct obstructions.

Keywords:
CNLDODCRDacryocystorhinostomydacryocystorhinostomyEndoscopyLacrimalMixed realityNasolacrimal nasolacrimal duct obstructionSALDOVirtual virtual reality

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Area of Science:

  • Ophthalmology
  • Surgical Technology
  • Medical Imaging

Background:

  • Complex nasolacrimal duct obstructions present significant surgical challenges.
  • Traditional endoscopic dacryocystorhinostomy (DCR) may have limitations in highly distorted anatomy.

Purpose of the Study:

  • To evaluate the efficacy and techniques of virtual reality (VR) and mixed reality (MR)-assisted powered endoscopic DCR.
  • To assess the utility of VR and MR in managing complex syndromic congenital nasolacrimal duct obstruction (CNLDO) and post-traumatic secondary acquired lacrimal duct obstruction (SALDO).

Main Methods:

  • A prospective, non-randomized clinical study involving patients with complex CNLDO and SALDO.
  • Preoperative planning using VR models and intraoperative guidance with MR assistance.
  • Utilized 3D and real-time digital models for surgical navigation during endoscopic DCR.

Main Results:

  • VR models facilitated detailed preoperative assessment of altered anatomy.
  • MR provided intraoperative visualization without disrupting the endoscopic procedure.
  • Surgeons could virtually manipulate MR models for intricate anatomical study during surgery.

Conclusions:

  • VR and MR-assisted powered endoscopic DCR offer a viable alternative for extremely challenging cases.
  • This approach is particularly beneficial for complex syndromic CNLDOs and post-traumatic SALDOs with severe anatomical deformities.