Office procedures for the treatment of dacryocystitis and obstructed nasolacrimal passages in adults have only limited success. Irrigation and probing are frequently either unsuccessful or only of temporary relief. Inserting tubes into the nasolacrimal duct has been generally abandoned. The final alternative for a cure frequently is dacryocystorhinostomy. Current techniques usually require hospitalization and moderately complex instruments in the form of special drills, saws, and chisels.
The procedure described below has numerous advantages. There are no skin incisions and no bleeding. It can be repeated if necessary. A minimum number of instruments are used. It can be quickly performed in the office.
The operation is carried out as follows: 0.5% tetracaine (or other topical anesthesia) is instilled in the conjunctival sac and then injected into the lacrimal sac. Residual secretions are irrigated out. Local anesthesia (1% lidocaine [Xylocaine]) is injected in the lacrimal sac area over the bone and also
BEDROSSIAN RH. Office Dacryocystorhinostomy. Arch Ophthalmol. 1965;73(3):356-358. doi:10.1001/archopht.1965.00970030358012