MANY ophthalmologists prefer not to perform external dacryocystorhinostomy, and some others perform the procedure so infrequently that the percentage of good results is discouraging. The purpose of this paper is to describe a simple diathermy technique which will increase the cure rate following this difficult operation. External dacryocystorhinostomy, performed in the routine manner, is more effective when the mucosal flaps are fashioned differently and cautery is used to enlarge the membranous anastomosis.
After a large amount of the bone which separates the lacrimal sac from the nasal mucosa has been removed, fashion flaps of the lacrimal sac mucosa and of the nasal mucosa so that they are hinged anteriorly and later can be sutured together. (In adults, the osseous anastomosis should be approximately 15 mm in diameter.)To enlarge the membranous anastomosis between the lacrimal sac and the nasal cavity, apply diathermy (high frequency voltage) (beginning about 2 mm
Veirs ER. The Use of Cautery in External Dacryocystorhinostomy. Arch Ophthalmol. 1969;82(4):489-490. doi:10.1001/archopht.1969.00990020491013