Endocanalicular laser-assisted dacryocystorhinostomy. An anatomic study
P. S. Levin and D. J. StormoGipson
Department of Ophthalmology, Stanford (Calif) University School of Medicine.
In human cadaver specimens, a laser fiberoptic was advanced through the
canalicular systems to create fistulas between the nasolacrimal sac and
nose. A 400- to 600-microns, blunt-tipped quartz fiberoptic was then
advanced through the upper and/or lower canaliculus to the medial aspect of
the nasolacrimal sac. After 10 to 15 laser pulses (10 W for 0.1 second), a
2.5 x 2.5-mm fistula was created between the lacrimal sac and the nose just
anterior and inferior to the middle turbinate. Additional laser pulses can
further enlarge the fistula. Endocanalicular laser-assisted
dacryocystorhinostomy has potential advantages compared with endonasal
laser-assisted dacryocystorhinostomy, including the following: laser energy
is directed away from the eye; the technique resembles standard
nasolacrimal probing; and nasal endoscopy and instrumentation may prove
unnecessary.
