Endonasal and transcanalicular Er : YAG laser dacryocystorhinostomy

In the last 10 years different types of lasers were used for dacryocystorhi nostomy (DCR). Between April 1996 and August 1999, a fibreoptic erbium lase r DCR was performed on 12 patients. Eight cases were for a presaccal stenos is and 4 cases for a postsaccal stenosis. An erbium laser with a specially designed handpiece was used endonasaly and transcanaliculary. Preoperative epiphora was present in all patients. Double bicanalicular nasal silicone t ubes were placed during surgery in all cases. The 3 cases of postoperative failure included 2 cases of presaccal stenosis and 1 case of the postsaccal group; failure manifested with recurrent epiphora/dacryocystitis ; the ons et of symptom recurrence varied from 9 weeks to 11 weeks postoperatively. L aser-assisted DCR includes the avoidance of a cutaneous incision, excessive tissue injury, the advantage of short operation time and precision. Suitab le indications for the erbium laser are stenoses in the canaliculi, in the sac, but also for bone lacrimal bone cutting.