Endoskopische Behandlung von Tränenwegsstenosen mit Hilfe eines KTP-Lasers - erster Erfahrungsbericht

Abstract

Background Since four years, endoscopes with which the mucosa and disorders of the lacrimal drainage system can be examined directly, are available. The wish to treat lacrimal disorders with endoscopes and laser have remained. Patients and Methods Between January 1996 and February 1997, 12 patients with acquired lacrimal stenosis were treated with an Hyb:Erbium-YAG-laser and 32 patients were treated with a KTP-laser (quasi-cw mode. wavelength 532 nm and 1 0 W power). Five patients were treated for lower canaliculus stenosis and seven patients for postsaccal stenosis with the Hyb:Erbium-YAG-laser. 32 patients with postsaccal stenosis were treated with the KTP-laser to perform a bony window of 5 x 5 mm. Bicanalicular intubation into the nose was performed and was left for at least three months. Results The longest follow up period was 30 months while the shortest was 13 months in the Hyb:Erbium-YAG-laser group. Treatment was successful in four cases with a canalicular stenosis, but restenosis occurred in all cases of postsaccal stenosis and in one case of canalicular stenosis and required a conventional DCR. In the KTP-laser group 25 patients are patent and have no symptoms, 4 patients have watering cold weather and patients had a restenosis. Foliow-up range between 2 months and 12 months. Conclusions The Hyb:Erbium-YAG-laser is succesful in thin membranes and small restenosis. With the KTP-laser a successfull transcanalicular laser assisted DCR is possible.