DACRYOENDOSCOPY AND LASERDACRYOPLASTIC - MANAGEMENT AND RESULTS

Background In a bicentrical study in the eyeclinic of Darmstadt and th e eyeclinic of the St. Josef Hospital Hagen 261 dacryoendoscopies were performed until February 1997. Materials and Methods In 261 dacryoend oscopies (143 women, 93 men and 25 children, the average age was 46,6 years). In dependance of the assessment of the mucosa conditions intra operatively in all 261 cases the planed operative strategy was checked and if needed changed. After surgical interventions of the lacrimal s ystem 70 cases of dacryocystorhinostomia externa were been 138 cases o f intubation of the lacrimal drainage system and 53 cases of laserdacr yoplastic. Intubation of the lacrimal system was always performed afte r laserdacryoplastic and after a patency was produced (average age 58, 3 years). Results Suitable indications for a laserdacryoplastic are: c ircumscribed stenosis of the distal saccus, pointsized stenosis of the canaliculus, membranous restenosis after dacryocystorhinostomia exter na. The method shows no important rate of intraoperative complications , only in one case there was intraoperatively a protrusio bulbi and a haematoma of the eyelid, which postoperatively eased fastly away. The postoperative convalescence is in comparence to conventional surgical interventions of the lacrimal drainage system enormously shortened. Th e follow-up after 3 months shoved a subjective improvement of epiphora in more than 75% of the patients, the sucess of this intervention the refore could be compared with conventional surgical methods of the lac rimal drainage system. Conclusion The dacryoendoscopy is a new importa nt diagnostic developement, which shows with help of better developed endoscopy-systems compared to previous systems a much better quality o f the image and is therefore a valuable diagnostic help. Due to the ch eck of the preoperative indication it is intraoperatively possible to confirm or, if needed, to change the indication after dacryoendoscopy. The laserdacryoplastic is an important new therapeutical developement of the dacryoendoscopy and shows in suitable indications a comparable sucess-rate of conventional surgical interventions of the lacrimal dr ainage system. Therefore the possibility exists to carry out minimal i nvasive interventions of the lacrimal drainage.