Laser DCR (transcanalicular laser-assisted DCR; laser dacryocystorhinostomy; LDCR)
This modern and still quite-rare-in-the-world surgical technique treating nasolacrimal duct obstruction has become in recent years an alternative to traditional dacryocystorhinostomy from the external approach (DCR). The essence of both these techniques is to produce a shunt between the lacrimal sac and the nasal cavity, so that tears can be re-discharged into the nasal cavity, and tearing is ceased.
Conventional DCR is performed from the external approach, ie. the facial skin incision. After reaching the lacrimal bone, which is part of the wall of the nasal cavity, an osteotomy is performed. In this way, a channel between the lacrimal sac and the nasal cavity is created, which is the goal of treatment. Then the lacrimal paths are intubated with a silicone tube and the wound is sutured. The operation is performed under general anesthesia.
Laser DCR (LDCR) is a modern technique of introducing into the lacrimal sac a thin fiber coupled with a diode laser (through the lacrimal canaliculi) to perform an osteotomy in the lacrimal bone. As soon as the lacrimal sac is reached the laser is activated, and the channel into the nasal cavity is formed. Everything is under the control of a nasal endoscope. This kind of laser treatment produces very little bleeding. It is performed by ophthalmic-ENT team, under local anesthesia. There are no incisions on the skin of the face. The surgery ends with the intubation of the tear paths.