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May 1971

A Simplified Dacryocystorhinostomy1954-1970

Author Affiliations

From the Wilmer Institute, Johns Hopkins Hospital and Medical School, Baltimore.

Arch Ophthalmol. 1971;85(5):586-591. doi:10.1001/archopht.1971.00990050588011

"A SIMPLIFIED Dacryocystorhinostomy,"1 as published in 1954, is reviewed after 15 years of use. The slight changes in technique are noted, and the success-failure rate is analyzed.

As mentioned in 1954, most obstructions in the lacrimal passages occur in the lower portion of the sac or in the bony nasolacrimal duct. Obstruction at these points can be handled successfully with dacryocystorhinostomy. The establishment of the exact site of the obstruction is therefore of crucial importance, since pathological conditions of the upper end of the lacrimal passage cannot be cured by this method.

Examination of the nose to rule out a badly deviated septum, a chronic sinusitis, or nasal polyps is basic, and any such pathological condition should be corrected before a sac operation is undertaken. If there is free regurgitation of mucopurulent material from the upper and lower lid puncta when pressure is applied over a dilated sac, the

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