[Lacrimal duct endoscopy. Report of initial experiences]

Abstract

Background: Until recently, we have had to depend on digital dacryocystography and on clinical examinations such as the fluorescein dye test, lacrimal probing and irrigation for diagnosis of disorders of the lacrimal system. Now the lacrimal system and its mucuos membranes can be viewed directly with a lacrimal endoscope. While the first endoscopes were rigid and limited by poor picture quality in axial illuminations, the new generation of endoscopes are a great leap forward for new diagnostic and therapeutic approaches.

Materials and methods: A new lacrimal endoscopic system has been in used at the University Eye Clinic in Graz since January 1996. The outer diameter of the endoscopes are 0.5 and 0.3 mm. The endoscope produces high-quality images with 3000 picture fibers and 200 light fibers. The unit consits of xenon light sources, a three-chip videocamera and a monitor.

Results: Diagnostic endoscopic lacrimal probing was performed on 38 patients whose ages ranged from 8 months to 73 years. Canaliculus scars and strictures, obstructions at the entrance and exit of the lacrimal sac, and scars and structures of the lacrimal sac and nasolacrimal duct were diagnosed.

Conclusion: Lacrimal endoscopy offers a new approach to the diagnosis of lacrimal disorders. Scars and relative obstructions can be identified more easily and can be directly opened with a laser or through mechanical probing. Perforations and massive mucosal injuries can be avoided. Further development of various types of lasers could allow for intracanalicular dacryocystorhinostomy, help prevent complications and increase the result.