Diagnosis of lacrimal duct diseases

Diagnosis of lacrimal duct disease with micro-endoscope.

There are many methods of lachrymal duct diagnosis. We are the only medical center in Poland that has a micro- endoscope for intra-operative diagnosis and simultaneous laser occlusion of lacrimal ducts. This valuable method allows for full visualization of lacrimal duct interior throughout the whole course, which enables precise reconstruction ; unlike endoscope nasal -through surgery that makes it possible to create a connection between lacrimal sac and nose

Surgery of lucrimal ducts

Our Center has been specializing on treatment of lacrimal organ diseases. Up till now , we have performed over 1300 DCR surgeries using laser micro-endoscope surgeries, and even more by classical methods in the past .All known methods of lacrimal duct treatment are performed by us.

The micro- endoscopic method is an ultramodern one, which makes it possible to reconstruct patency of lacrimal ducts at various disease stages.

This method allows both lacrimal duct reconstruction and simultaneous examinations in children and adults. In this way, the number of anesthesia practices is limited and X-Ray exposition avoided. This method may be applied even to very little patients while adults require only local anesthesia. Moreover, surgery leaves no scares, and there is no need to stay in hospital as it may be performed in one day.

Methods of endoscope patency in lacrimal ducts:

• Micro-endoscopy of lacrimal ducts : this precious method allows for full visualization of lacrimal duct interior on the whole course, which makes it possible to reconstruct it precisely, unlike nasal- through endoscopy, where only creating a connection between lacrimal sac and nose is possible. Diagnosis and treatment may be carried out at any age of patient. Treatment is performed by laser.
• Endoscope  technique : is also performed at our Center and allows full  visualization of nasal cavity. It is only possible to create a connection between lacrimal sac and nasal cavity. This method does not make it possible to see other pathologies, and therefore is  rarely used.
• Classical technique : performed frequently before micro-endoscopy was implemented. The idea was to cut the skin at the medial angle of eye and cut out a bone piece ,followed by  connecting lacrimal sac with nasal cavity at present this method is rarely used, mainly in cases of big post traumatic changes.

What does the treatment consist in?

The procedure involves inserting an ultra miniature endoscope into tubules by means of which, it finds the lacrimal duct damages (scars, stenosis, or even improperly developed tubule fragments). After finding locations of pathology, laser starts up and performs a reconstruction of lacrimal ducts . The treatment ends with fixing small silicone tubes (for a period of about 6 months), which protect the operative site against overgrowing. With application of this method, all types of lacrimal obstruction can be cured.

More information

Occluded tubules in children

Quite a common problem in children is closed nasal-lacrimal duct, causing usually tearing and suppuration  in the  eye. In very young children, it is recommended to massage the area. If there is no spontaneous patency or the child’s condition , the doctor should perform  probing of lacrimal ducts ( such a treatment is performed at our Center under local anesthesia). If it  does  not give a positive effect, micro- endoscopy of lacrimal ducts and possibly simultaneous laser treatment should be considered.

Post – traumatic occlusion of tubules

A common complication of facial skeleton trauma is lesion  of lacrimal ducts. This problem may be  solved only by  reconstruction of tubules and, in extreme cases,  CDCR surgery  (conjunctvodacryocystomy) involving the implantation of silicone or glass tube, permanently draining  tears. At our center, the CDCR procedures are also performed by using laser techniques, without  leaving scars.

Excessive tearing

Excessive tearing  may also result from other causes than  obstruction, among other things: excessive flaccidity  of the eyelids, incorrect setting of  lacrimal points , abnormal shape and size of the  tear duct warts ,  lacrimal pump dysfunction, vision defects, allergies, etc.
To improve the drainage of tears, plastic surgeries  of eyelids  are often necessary, and they are  also performed at  our Center.

Persistent suppuration of eye

It can also be caused by obstructive lacrimal ducts . There is no chance of  getting  improvement and permanent recovery   if the lacrimal ducts are not patent  . The frequent use of antibiotics can lead to the formation of mycotic  inflammation of conjunctivac sac and  lacrimal  ducts.
Such a   condition requires prompt surgical intervention and carrying out  general and local treatment.

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