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October 1992

Endocanalicular Laser-Assisted Dacryocystorhinostomy: An Anatomic Study

Author Affiliations

From the Department of Ophthalmology, Stanford (Calif) University School of Medicine (Drs Levin and StormoGipson) and the Palo Alto (Calif) Veterans Hospital (Dr Levin). The authors have no proprietary or commercial interest in the devices used in this study.

Arch Ophthalmol. 1992;110(10):1488-1490. doi:10.1001/archopht.1992.01080220150037

• In human cadaver specimens, a laser fiberoptic was advanced through the canalicular systems to create fistulas between the nasolacrimal sac and nose. A 400- to 600-μm, blunt-tipped quartz fiberoptic was then advanced through the upper and/or lower canaliculus to the medial aspect of the nasolacrimal sac. After 10 to 15 laser pulses (10 W for 0.1 second), a 2.5 × 2.5-mm fistula was created between the lacrimal sac and the nose just anterior and inferior to the middle turbinate. Additional laser pulses can further enlarge the fistula. Endocanalicular laser-assisted dacryocystorhinostomy has potential advantages compared with endonasal laser-assisted dacryocystorhinostomy, including the following: laser energy is directed away from the eye; the technique resembles standard nasolacrimal probing; and nasal endoscopy and instrumentation may prove unnecessary.