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An Endoscopic Approach for the Management of Congenital Lacrimal Fistulae

Ross, Jonathan J. F.R.C.Ophth.; Patel, Vikesh F.R.C.S.Ed.; Malhotra, Raman F.R.C.Ophth.

Ophthalmic Plastic & Reconstructive Surgery: May-June 2011 - Volume 27 - Issue 3 - p e48-e49
doi: 10.1097/IOP.0b013e3181cc88b0
Case Reports

A 26-year-old male presented with left epiphora from a congenital lacrimal fistula. A dacryocystogram confirmed fistulous origin from the lacrimal sac, while syringing demonstrated coexisting partial nasolacrimal duct obstruction. Endoscopic dacryocystorhinostomy was performed with marsupialization of the lacrimal sac medial wall, facilitating direct visualization of the internal fistula origin on the lateral wall, and excision with a 3-mm punch biopsy trephine over a cannula guide. Postoperatively, his symptoms resolved with a minimal cutaneous scar. The authors present this modified surgical technique for fistula excision using an endoscopic dacryocystorhinostomy approach.

Queen Victoria Hospital, East Grinstead, United Kingdom

Accepted for publication November 7, 2009.

The authors have no financial or proprietary interest in any of the material contained in this report.

Address correspondence and reprint requests to Raman Malhotra, F.R.C.Ophth., Queen Victoria Hospital, Holtye Road, East Grinstead, United Kingdom RH19 3DZ. E-mail:

©2011The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.