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Transcanalicular Laser-Assisted Dacryocystorhinostomy

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Oculofacial, Orbital, and Lacrimal Surgery

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Abstract

In the search of the ideal dacryocystorhinostomy (DCR) that avoids a surgical scar in the medial canthus, transcanalicular laser-assisted dacryocystorhinostomy (TCL-DCR) is considered a fast and relatively simple alternative procedure for the management of nasolacrimal duct obstruction. The success rates of TCL-DCR are between 34% and 95.2%, and anatomical success rates up to 100% have been published. The functional failure rate of TCL-DCR is higher, often related to a sump syndrome in the majority of patients, when compared to non-laser-assisted DCR methods. Complications, such as tissue necrosis and proximal lacrimal drainage system trauma, have been reported. Surgical modifications to decrease the amount of laser energy delivered have resulted in better anatomical and functional outcomes.

In this chapter, transcanalicular laser-assisted dacryocystorhinostomy is presented, including its historical evolution, types of lasers used, indications, and surgical techniques. Advantages and disadvantages of this approach, techniques for optimizing outcomes, and complication avoidance and management are discussed.

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The author has no financial interest in any of the materials or equipment used in the chapter.

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  1. Rufus Eye Microsurgical Center, Ophthalmic Plastic and Reconstructive Surgery Division, Istanbul, Turkey

    Pelin Kaynak

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  1. Eyelid and Facial Plastic and Reconstructive Surgery and MediSpa, Diseases and Surgery of the Orbit & Lacrimal System Neuro-ophthalmology, Glenview/Chicago, IL, USA

    Adam J. Cohen

  2. Oculoplastics, Orbital, and Cosmetic Facial Surgery, University of Wisconsin, Madison Department of Ophthalmology and Visual Sciences, Madison, WI, USA

    Cat Nguyen Burkat

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Kaynak, P. (2019). Transcanalicular Laser-Assisted Dacryocystorhinostomy. In: Cohen, A., Burkat, C. (eds) Oculofacial, Orbital, and Lacrimal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-14092-2_46

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