Dacryoendoscopic Guided Canalicular and Nasolacrimal Duct Recanalization

Abstract

Dacryoendoscopy is a procedure utilizing microendoscopic techniques to visualize the entire lacrimal system from the puncta to the inferior meatus [1–10]. It is gaining firm ground and increasing in popularity for expanding indications in lacrimal disorders, thus having many diagnostic and potential therapeutic implications [1–10]. Till the late 1990s, the microendoscopic systems were not well-developed; however, with the advancement in other specialties like endoscopic retrograde cholangiopancreatography (ERCP), numerous microendoscopes with a good image quality were designed. Dacryoendoscopes used in the past include the Junemann probe and the vitroptic. Additional channels were added, for example, for laser delivery of KTP-YAG or Erbium-YAG laser for laser dacryoplasty and micropunches for sample collection [8]. The author performs it using a 0.6-mm microendoscope (Karl Storz, Tuttlingen, Germany), which was adapted and partly modified from the original sialoendoscope (Figs. 32.1 and 32.2). The current chapter will discuss the instruments, indications, and techniques of lacrimal passage recanalizations.