Surgical considerations for dacryocystorhinostomy with special emphasis on hemostatic techniques.

Thirty patients were treated. All surgical procedures were carried out without technical difficulty. Estimated blood loss varied between 5 ml and 25 ml. In no case did bleeding obscure the operative field. Two patients did experience transient hypertension after injection of lidocaine with epinephrine. This was easily controlled by the anesthesiologist. After follow-up periods ranging from one year to five years, all patients have achieved a satisfactory result. No recurrent epiphora or infection has been noted. The technique described in this communication involves drugs, instruments, and equipment which have made our dacryocystorhinostomy rapid (35 to 45 minutes), controlled, and predictable. Surgical morbidity is negligible. Hemorrhage is no longer a fearsome problem. Exposure is always adequate. And, above all, uniform success has been very gratifying to surgical patients and surgeons.