Primary Endocanalicular Laser Dacryocystorhinostomy

Abstract

External Dacryocystorhinostomy (Ex-DCR) is the current gold standard in the treatment of primary acquired nasolacrimal duct obstruction (PANDO). Description of a transcanalicular DCR was first published in 1963 by Jack [1]. In recent years endoscopes have been modified and are now able to visualize the canaliculus, sac, and duct. Similarly, lasers have evolved and are smaller, portable with thinner diameter fiber optics, and can be inserted through small orifices like the canaliculus. All these advances in endoscopy and laser technology led to the discovery of endocanalicular laser dacryocystorhinostomy (ECLDCR). Levin and Silkiss were the first ones to describe this laser technique using cadavers in 1992 [2, 3]. Micahalos et al. also followed suit with cadaveric studies with ECLDCR in 1995 [4]. Christenbury was the first to perform ECLDCR in patients using an argon laser [5, 6]. Since then, numerous clinical articles have been published using ECLDCR with varying success rates at 47–97 % [5–30].