Dacryoendoscopy, microdrill-dacryoplasty and silicone tubing of the lacrimal drainage system
R.-L. Mertè, M. Maier, T. Schmidt, M. Schmidt
Purpose: Dacryoendoscopy is an important intraoperative diagnostic procedure in patients with lacrimal outflow obstruction. Since several years it is possible to perform additional endoscopic controlled surgery. We present our results of patients treated by microdrill-dacryoplasty and silicone tubing.
Methods: For microinvasive lacrimal surgery we use a 1,1 mm endoscope (Vitroptik T ®) with a wash cannula, a channel for the microoptic and a channel for a microdrill. The results of 25 patients with stenosis of the lacrimal outflow system (23 punctual stenosis, 2 restenosis after DCR), being treated with the endoscopic microdrill (microdrill-dacryoplasty) and silicone tubing are reported.
Results: Using the dacryoendoscope (Vitroptic T) we were able to visualize pathologic changes of the lacrimal outflow system. In all patients with microdrill-dacryoplasty recanalisation of the lacrimal drainage system under endoscopic control was possible. 3 month after surgery 80 %, and 6 month after surgery more than 80 % showed patency of the lacrimal outflow system with the silicone tube in place. In more than 85 % of these patients symptoms (epiphora) improved.
Conclusions: Dacryoendoscopy and endoscopic controlled surgery of the lacrimal drainage system enables an atraumatic and minimal invasive surgery. Our short-term results in patients with punctual stenosis and restenosis after DCR are promising, long-term results remain to be seen.
Augenklinik rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 München