ENDOSCOPIC LASER DACRYOCYSTORHINOSTOMY

Endoscopic laser dacryocystorhinostomy (DCR) enables an obstructed lac rimal sac to be opened through an intranasal approach, avoiding the ne ed for a skin incision. The holmium:yttrium aluminum garnet (holmium:Y AC;) laser is well-suited for this procedure because of its properties of fiberoptic delivery, effective bone cutting, and precise soft-tiss ue coagulation. Efficient bone ablation is particularly important for primary DCR which requires removal of relatively thick bone along the lateral nasal wall to expose the lacrimal sac. Forty-six endoscopic la ser DCRs were performed on 40 patients. There were no intraoperative o r postoperative complications. The surgery successfully relieved lacri mal obstruction in 85% of patients. Endoscopic instrumentation allowed for the rapid identification and correction of intranasal causes of D CR failure, including ethmoid sinus disease and middle turbinate hyper trophy. Endoscopic laser DCR appears to be a safe and effective proced ure which should be considered as an alternative to external DCR for t he surgical treatment of nasolacrimal duct obstruction.