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A Novel Approach to Lacrimal Sac Dissection in Dacryocystorhinostomy

Saleh, George M. M.R.C.S.Ed., M.R.C.Ophth; Tsesmetzoglou, Eleni M.B.B.S.; Tossounis, Charalambos M. M.B.B.S.; McLean, Chris J. F.R.C.Ophth.

Ophthalmic Plastic & Reconstructive Surgery: March-April 2007 - Volume 23 - Issue 2 - p 171-172
doi: 10.1097/IOP.0b013e3180331393
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The use of membrane-peeling vitreoretinal forceps to facilitate lacrimal sac dissection in external dacryocystorhinostomy is demonstrated. The closed vitreoretinal forceps are advanced via the upper punctum and canaliculus, through to the lacrimal sac. They are then opened maximally providing two points of elevation. This maneuver allows for easier identification of the plane of dissection during lacrimal flap creation. It is especially useful with complex anatomy and for junior trainees in helping to orient the dissection. No tissue or instrument damage has been noted, and because many ophthalmic units have a vitreoretinal service, the forceps may be readily available at no extra cost.

The use of vitreoretinal forceps to facilitate lacrimal sac dissection in external dacryocystorhinostomy is described.

Department of Ophthalmology, Royal Surrey County Hospital, England.

Accepted for publication October 10, 2006.

This material was presented as a poster at the World Congress of Ophthalmology in Brazil, February 2006.

Address correspondence and reprint requests to George M. Saleh, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX; E-mail: drgmsaleh@yahoo.co.uk

©2007The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc.