[Conjunctivodacryocystorhinostomy with the assistance of diode laser. Endoscopic placement of Jones lacrimal tubes].

OBJECTIVE

To describe and assess a surgical technique for cases of complete bicanalicular lachrymal destruction by means of the endoscopic insertion use of the Jones tube with a diode laser to study functionality and complications.

PATIENTS AND METHOD

A descriptive study of a case series with 24 consecutive patients with complete bicanalicular obstruction who underwent conjunctivodacryocystorhinostomy with diode laser. The surgery time, intra-operative and post-operative complications, long-term patency, and need for secondary revision were evaluated.

RESULTS

Twenty-four consecutive patients were included in the study. All surgical procedures were successfully performed without significant complications. Average operating time was 15 minutes. The length of the tubes used ranged from 17 to 26 mm. Patients were evaluated at 24 hours, 3 weeks, 3 months, and 6 months and then every 6 months. The most frequent post-surgical complication was the downward migration of the tube towards the nasal fossa (37.5%). Secondary intervention was performed in 6 patients. Success was demonstrated using the fluoresceinic staining test under endoscopic monitoring and represented 37.5% after the initial surgery and 50% including revision surgery.

CONCLUSIONS

Laser-guided endoscopic intubation is a speedy and accurate surgical procedure that is well-tolerated during the operation and leaves no scar on the skin surface. However, it is associated with a considerable number of post-surgical complications.