Opening of lacrimal stenosis with endoscope and laser

Abstract

Since the development of lacrimal endoscopes with which the mucosa and disorders of the lacrimal drainage system can be examined directly, the choice of surgical technique has changed decisively. Flexible miniendoscopes can be combined with a laser for the first time, allowing for exact localization of the stenosis and subsequent therapy. Between January 1996 and February 1997, 12 patients with acquired lacrimal stenosis were treated with an Hyb:erbium-YAG laser. After endoscopic localization, the stenosis or stricture was opened using the laser. Bicanicular intubation into the nose was performed and was left for at least 3 months. Five patients were treated for stenosis of the lower canaliculus and seven patients for postsaccal stenosis. The longest follow-up period was 22 months and the shortest 9 months. Treatment was successful in 4 cases with a canalicular stenosis, but restenosis occurred in all cases of postaccal stenosis and in 1 case of canalicular stenosis, and required a DCR. At this time we conclude that disorders of the canaliculi can be successfully treated with endoscopic localization, opening with a laser and subsequent silicone tube intubation. A high rate of restenosis may be expected in cases of postsaccal stenosis.