A rigid GRIN-endoscope for endoscopy of the lacrimal drainage system

Background: Using small endoscopes it is now possible to evaluate the statu s of lacrimal ducts in vivo. GRIN-Lenses produce better pictures form the l acrimal ways than fiber-bundles. GRIN-endoscopes are rigid. The present stu dy is concerned with the feasibility and indications of such GRIN-endoscopi c examination. Patients and Methods: Two different GRIN-endoscopes with a distal diameter of 0.89 mm were used. One with a empty set 0.5 mm optic and an additional w orking channel and another one with a empty set 0.35 mm optic and two addit ional working channels. One channel each was used for injection of air or 0 .9 % NaCl. Either a laser fiber or another instrument (max empty set 0.16 m m) could be introduced into the second channel. 44 patients in age between 18 and 87 with symptoms of epiphora or signs of chronic lacrimal way affect ions were examined. Results: The presaccal lacrimal ducts could be clearly visualized in all pa tients. In case of presaccal stenosis, the examination of the lacrimal sac was not always possible. The endoscope used, based of GRIN-lenses, gave an excellent image quality. Endoscopy under local anesthesia was well tolerate d by all the patients with affection of the lacrimal drainage system. Becau se this ambulant examination does not stress the patient too much, it could be repeated a number of times. Endoscopy under general narcosis could enla rge the application spectrum. This method can complement the ambulant diagn ostics and therapy of the lacrimal drainage system.