Blocked Tear Ducts: Endoscopic and Laser Dacryocystorhinostomy

Topic Overview

Endoscopic dacryocystorhinostomy is a type of surgery sometimes used to treat blocked tear ducts in adults. It is rarely used in children. During this procedure, the surgeon inserts a thin fiber-optic light device through the tear duct opening (punctum) at the inner corner of the eyelid. This allows the surgeon to see where the tear duct is supposed to exit inside the nostril.

Next, the surgeon inserts an endoscope, a thin tube with a tiny camera on the end, into the nostril. An incision is made at the point where the fiber-optic light shines through the blocked tear duct. The incision opens a new passageway between the tear duct sac and the nasal cavity. The incision is done through the endoscope inside the nostril. There is no visible scarring after surgery.

This procedure may be done as an alternative to a standard dacryocystorhinostomy, which creates a new drainage canal and leaves a small scar.

Laser dacryocystorhinostomy uses an endoscope that also contains a laser, which is an intense, narrow beam of light that can cut through body tissues. The laser in the endoscope makes a hole in the nasal bone. This creates a connection between the tear duct sac and the nasal cavity.

Compared with similar types of surgery, laser dacryocystorhinostomy:

• Causes less bleeding.
• Does not always require general anesthesia.
• Can be done in a doctor's office.

But this type of surgery:

• Is often more expensive.
• Takes longer to do.
• Requires more specialized surgical skills.

Laser dacryocystorhinostomy may not be an option for some people.

Endoscopic and laser dacryocystorhinostomy are not as successful in opening blocked tear ducts as standard dacryocystorhinostomy.