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[Transcanalicular endodacryocystorhinostomy using Neodymium:YAG laser]
J M Piaton1, S Limon, N Ounnas
1Centre Hospitalier National d'Ophtalmologie des Quinze-Vingt, Paris.
Journal Francais D'Ophtalmologie
|January 1, 1994
Summary
A new transcanalicular dacryocystorhinostomy (DCR) laser technique creates a nasal fistula for tear duct obstruction. This minimally invasive approach offers a 75% success rate for primary and revision cases.
Area of Science:
- Ophthalmology
- Otolaryngology
Background:
- Tear duct obstruction causes significant visual impairment and discomfort.
- Traditional dacryocystorhinostomy (DCR) methods can be invasive with potential complications.
Purpose of the Study:
- To introduce and evaluate a novel transcanalicular dacryocystorhinostomy (DCR) technique using a Neodymium:YAG laser.
- To assess the efficacy and advantages of this minimally invasive DCR approach.
Main Methods:
- A metallic pipe was inserted through the canaliculus, followed by laser fiber insertion for translumination and fistula creation.
- A Neodymium:YAG laser delivered pulses to form a 5 mm lacrimo-nasal fistula.
- Silicone stents were placed for 6 months post-procedure in 41 patients.
Main Results:
- The transcanalicular laser DCR achieved a 75% success rate.
- This rate was consistent for both primary procedures and revisions of failed classical DCR.
Conclusions:
- The transcanalicular laser DCR is a simple, atraumatic technique with minimal bleeding and no scarring.
- It effectively treats obstructions at all levels of the excretory lacrimal system.
- Its minimal invasiveness makes it suitable for outpatient procedures.