Endoscopic and laser dacryocystorhinostomy for a blocked tear duct

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Endoscopic and laser dacryocystorhinostomy for a blocked tear duct

Endoscopic dacryocystorhinostomy is a type of surgery sometimes used to treat blocked tear ducts in adults. It is rarely used in children. During this procedure, an endoscope, a thin flexible tube with a tiny camera on the end, is inserted through the tear duct opening (punctum) at the inner corner of the eyelid. This allows the surgeon to see where the tear duct is supposed to exit inside the nostril.

An incision is made at the point where the fiber-optic light shines through the blocked tear duct. The incision opens a new passageway between the tear duct sac and the nasal cavity. The incision is performed through the endoscope inside the nostril. There is no visible scarring after surgery.

This procedure may be done as an alternative to a standard dacryocystorhinostomy, which creates a new drainage canal.

Laser dacryocystorhinostomy uses an endoscope that also contains a laser, which is an intense, narrow beam of light that can cut through body tissues. The laser in the endoscope makes a hole in the nasal bone, creating a connection between the tear duct sac and the nasal cavity.

Compared with similar types of surgery, laser dacryocystorhinostomy:

• Causes less bleeding.
• Does not require general anesthesia.
• Can be done in a doctor's office.

However, this type of surgery:

• Is often more expensive.
• Takes longer to do.
• Requires more specialized surgical skills.

Laser dacryocystorhinostomy may not be possible in some people.

Endoscopic and laser dacryocystorhinostomy are not as successful in opening blocked tear ducts as standard dacryocystorhinostomy.

Credits

Last updated:	April 11, 2008
Author:	Debby Golonka, MPH
Reviewed By:	Kathleen Romito, MD - Family Medicine, Christopher J. Rudnisky, MD, FRCSC - Ophthalmology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC