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Transcanalicular Laser-Assisted Dacryocystorhinostomy

  • Pelin Kaynak
Chapter

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.

Keywords

Dacryocystorhinostomy Endocanalicular Lacrimal surgery Laser dacryocystorhinostomy Nasolacrimal duct obstruction Scarless lacrimal surgery Diode laser Holmium YAG laser Laser complications Functional epiphora 

Notes

Financial Disclosures

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

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Pelin Kaynak
    • 1
  1. 1.Rufus Eye Microsurgical Center, Ophthalmic Plastic and Reconstructive Surgery DivisionIstanbulTurkey

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