Lacrimal sac identification in dacryocystorhinostomy surgery

The intraoperative identification and opening of the lacrimal sac is generally performed by cutting down on the tip of a lacrimal probe passed down one canaliculus. While easily performed in most cases, this step is frequently associated with difficulty, confusion, and orbital fat exposure particularly if the internal common punctum is imperforate or the sac is scarred. The authors present an alternate method for opening the sac based upon simple anatomic concept.