Rekanalisierung von Tränenwegsstenosen mittels Laserdakryoplastik unter Verwendung eines Diodenlasers – Vergleich der Erfolgsraten zum Erbium-YAG-Laser

Abstract

In a retrospective study, the success rates of laserdacryoplasty using a diode laser were defined and compared to success rates using an erbium : YAG laser. Using a diode laser at a wave length of 980 nm, thermal destruction of tissue leads to recanalization. Using an erbium : YAG laser at a wave length of 2940 nm, recanalization of punctual stenosis is achieved by formation of a cavitation bubble in a closed system. 94 patients (64 women, 30 men, mean age 60.8 years) with 107 absolute lacrimal duct stenoses who were treated by laserdacryoplasty using a diode laser were included in a retrospective study. First dacryoendoscopy was performed in general anesthesia showing 40 canalicular and 67 saccal stenoses. As for being punctual, complete stenoses indication for laserdacryoplasty was given. Recanalization was followed by bicanalicular intubation with silicon tubes being left for 95 ± 37 days on average. Lacrimal irrigation was performed in 75 cases of 65 patients 3 months after operation. Approximately 12 months postoperatively, 61 patients were questioned about epiphora and their satisfaction. After 3 months, irrigation was successful in 70.7%, less or no epiphora could be observed in 62.9%, 60% of the patients were satisfied with the result and complication rate was low. In case of saccal stenosis, irrigation was successful in 78.7%, and in cases of canalicular stenosis, irrigation was successful in 57.2%. Clear reflux preoperatively showing no indication of inflammation was prognostically favorable as well as a short duration of symptoms. Laserdacryoplasty using a diode laser shows similar results as using an erbium : YAG laser. This minimally invasive technique rarely leads to complications and is suitable for therapy of punctual canalicular and saccal stenoses.

Clinical Implication of Dacryoendoscopy in the Patients with Tearing: A Systematic Review

“…But it is also found that a higher rate of postoperative complications such lacrimal bleeding and/or palpebral edema as compared to previous laser dacryoplasty [ 9 ]. Laser dacryoplasty for nasolacrimal recanalization has been in use for more than two decades [ 10 ]. The lasers employed include Nd-YAG, THC:YAG, Erbium:YAG, and the Diode laser [ 10 ].…”

“…Laser dacryoplasty for nasolacrimal recanalization has been in use for more than two decades [ 10 ]. The lasers employed include Nd-YAG, THC:YAG, Erbium:YAG, and the Diode laser [ 10 ]. The laser probes can be passed through the working channel into the NLD and then can be directly applied to the obstructed tissue with an end-on dacryoendoscopic visualization [ 9 ].…”

Tränenwegsstenosen im Erwachsenenalter

“…Langstreckige absolute Stenosen mit postsakkaler Lokalisation eignen sich weniger für eine DE. Insgesamt liegt der Langzeiterfolg bei etwa 60 %, kann aber durchaus bei relativer präsakkaler TNW-Stenose über 80 % betragen [25,29,30]. Nach einer endoskopischen Rekonstruktion werden die TNW vorübergehend durch Silikonverweilsonden gesichert (▶ Abb.…”