Intranasal laser-assisted dacryocystorhinostomy with the use of a surgical microscope

PURPOSE: Obstruction of the nasolacrimal duct is a serious chronic condition, treatment for which has not yet been successfully resolved. Several methods have been proposed for the management of chronic epiphora. A modified method of intranasal laser-assisted dacryocystorhinostomy with the use of a surgical microscope is described. MATERIALS AND METHODS: The procedure is a modification to the West and Veis-Claus-Guttich method. The primary and late results of this method are presented for 53 patients over the past 7 years with chronic epiphora caused by stenosis of the nasolacrimal duct. Selection criteria included chronic epiphora, nasolacrimal duct stenosis due to Down syndrome, empyema of the lacrimal sac, and recurrence from previous operations. Patients were operated on under general anesthesia. RESULTS: Fifty-one patients (96.3%) were free of symptoms postoperatively (mean follow-up time, 6 months). CONCLUSION: The simplicity of this method compared with traditional methods is correlated with excellent postoperative results and patient satisfaction.