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[Lacrimal surgery]

C Bosshard

    Klinische Monatsblatter Fur Augenheilkunde
    |April 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

    Surgical interventions can restore tear drainage disrupted by blockages or disconnections in the lacrimal drainage system. Procedures include punctal surgery, canalicular repair with silastic tubing, and dacryocystorhinostomy for effective tear flow restoration.

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    Area of Science:

    • Ophthalmology
    • Surgical Anatomy

    Context:

    • Tear drainage pathways are crucial for ocular health, and their disruption can lead to various visual disturbances.
    • Anatomical abnormalities or obstructions within the lacrimal drainage system, including the puncta, canaliculi, and lacrimal sac, impede normal tear flow.

    Purpose:

    • To review and discuss surgical techniques for reconstructing the lacrimal drainage system.
    • To outline treatment strategies for different types of tear drainage obstructions, from punctal issues to canalicular blockages and lower system obstructions.

    Summary:

    • Surgical options for tear drainage restoration include punctal surgery (one-snip, two-snip, Bangerter's plasty), internal splinting of torn canaliculi with silastic tubing, and intubation for canalicular obstruction.
    • Complications of silastic intubation include corneal and conjunctival ulcers, punctal slitting, and nasal ostium closure. Direct anastomosis is an option when canalicular reconstruction fails.

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  • Dacryocystorhinostomy is the primary surgical approach for obstructions below the lacrimal sac. Congenital nasolacrimal duct obstruction is managed sequentially with conservative measures, hydraulic flushing, and probing.

    • Impact:

    • Provides a comprehensive overview of surgical interventions for restoring functional tear drainage.
    • Highlights potential complications associated with intubation techniques, informing clinical decision-making.
    • Offers a tiered approach to managing congenital nasolacrimal duct obstruction, emphasizing conservative measures first.