Endonasal and transcanalicular Er:YAG laser dacryocystorhinostomy.

In the last 10 years different types of lasers were used for dacryocystorhinostomy (DCR). Between April 1998 and August 1999, a fibreoptic erbium laser DCR was performed on 12 patients. Eight cases were for a presaccal stenosis and 4 cases for a postsaccal stenosis. An erbium laser with a specially designed handpiece was used endonasaly and transcanaliculary. Preoperative epiphora was present in all patients. Double bicanalicular nasal silicone tubes were placed during surgery in all cases. The 3 cases of postoperative failure included 2 cases of presaccal stenosis and 1 case of the postsaccal group; failure manifested with recurrent epiphora/dacryocystitis; the onset of symptom recurrence varied from 9 weeks to 11 weeks postoperatively. Laser-assisted DCR includes the avoidance of a cutaneous incision, excessive tissue injury, the advantage of short operation time and precision. Suitable indications for the erbium laser are stenoses in the canaliculi, in the sac, but also for bone lacrimal bone cutting.