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February 1992

Translacrimal Laser Dacryocystorhinostomy-Reply

Author Affiliations

Milwaukee, Wis

Arch Ophthalmol. 1992;110(2):171. doi:10.1001/archopht.1992.01080140020010

In Reply.  —I thank Dr Christenbury for his kind comments regarding our original description of endonasal laser dacryocystorhinostomy (ENL-DCR) for the treatment of lacrimal outflow obstruction. I offer the following comments regarding his work.In our initial cadaver research we investigated transcanalicular passage of a 300-μm quartz fiberoptic catheter to produce a laser DCR fistula using a 16-W argon blue-green laser. The optical fiber suffered damage when used in this contact mode, causing reduced tissue cutting efficiency and increased collateral tissue damage as evidenced by post-procedure dissections. The quartz fiber described by Dr Christenbury is intended for intraocular endophotocoagulation and would be expected to present the same disadvantages. When using a transcanalicular technique, it is more difficult to control the exact site of fistula placement, and lacrimal sac mucosal damage is not directly observed. Although this route may be less cumbersome and more familiar to the ophthalmologist, the intranasal approach

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