Steinkogler F J
Univ. Augenklinik Wien.
Klin Monbl Augenheilkd. 1987 Nov;191(5):349-51. doi: 10.1055/s-2008-1050525.
Fistulas of the lacrimal sac are visible as small openings in the skin of the medial canthus. They can cause inflammations and serous or mucous secretions. Additional canaliculi of this type can be demonstrated by dacryocystographic techniques. Under the operating microscope the fistula is exposed as far as the lacrimal sac and then excised. The lacrimal sac and the nasolacrimal duct are examined. If there is no further stenosis a dacryocystorhinostomy is not necessary. After bicanalicular silicone intubation the wound is closed layer by layer. If primary healing occurs without complications dense closure results and there is no danger of fistulas of the lacrimal sac redeveloping.