In dissecting the lacrimal sac for the purpose of dacryocystectomy or for effecting permanent drainage by one of the several well described methods, the surgeon usually experiences difficulties of two kinds: first, excessive bleeding which constantly obscures the operating field and, second, loss of anatomic orientation.
These difficulties are easily remedied by a slight modification of the operative technic, and operation on the lacrimal sac, which is frequently considered as technically rather difficult, becomes a simple and clean procedure.
The one refinement of the technic consists in using a higher concentration of epinephrine in the procaine hydrochloride used for infiltration anesthesia. The usual surgical concentration of epinephrine is 1: 100,000 in 1 or 2 per cent procaine hydrochloride. By adding to this epinephrine-procaine hydrochloride mixture, obtained in ampules, 1 drop of sterile, but not boiled or autoclaved, solution of epinephrine (1: 1,000) for each cubic centimeter of
Hulka JH. AN IMPROVED TECHNIC FOR DISSECTION OF THE LACRIMAL SAC. Arch Ophthalmol. 1935;14(1):109–111. doi:10.1001/archopht.1935.00840070121010
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