Endoscopic Tear Duct Surgery

Tear duct occlusions are most common in newborn babies and women who have reached the age of 40, but can affect all ages and all genders. It is expected until 1 year old for intervention in infants, but it should be intervened immediately in adults. Massage therapy is applied to infants up to one year of age. If it does not open, an intervention is made. The first intervention is probing. Surgery is not prioritized. In adults, on the contrary, it should be intervened immediately. The first intervention is lavage application. Pressurized liquid is given by entering the channel.

However, not every eye watering does not mean ‘clogged tear duct’.

As a result of the irritation of the retinal layer of the first eye or the vascular region, the tear secretion may increase as a reflex. These situations are; allergies, foreign objects in the eye, exposure to caustic substances and injuries.

2. There may be actual tear duct obstructions. Causes of lacrimal duct obstructions; There may be nasal bone curvatures, duct obstructions due to eye infection, long-lasting allergies, flesh growths in the nose, and blows to this area.

3. There are also situations that cause irrigation even though there is no real blockage in the canal; This is pump failure. It may be due to laxity of the lower eyelid, paralysis of the facial lines, or weakness of the eyelid muscles.

However, the patient should be examined to see if there is a real tear duct obstruction. Because, in newborn babies, increased eye pressure, eye injuries, foreign objects in the eye, and allergy can cause eye watering.

In adults, it can be caused by allergies, ingrown eyelashes, damage to the retinal layer of the eye, facial paralysis, eyelid disorders, facial injuries.

Tear duct obstructions can be at any level; There may be stenosis of the duct mouth, the inlet duct may be obstructed, or there may be an obstruction or adhesion of the cat of the sac.
Tear duct obstructions cause frequent infections. If these infections are not treated, the infection tends to spread to the eyelids and face. As a result of bumin, orbital cellulitis, sinusitis and even meningitis may develop. There is a risk of infection in cataract surgeries in patients with lacrimal duct obstruction.
The treatment of lacrimal duct obstructions is done surgically. First of all, probing method is applied in children. If the canal is not opened, ritleng type can be applied in children up to 4 years old. In children older than four years, surgical methods are applied in the same adult.
In adults, lavage is applied first, and if there is no success in lavage (pressurized fluid into the tear duct), surgical method is applied. The 2 most applied surgical methods today; 1- With the help of a video camera, a new channel is opened through the nose and a silicone tube is inserted into the nose. This tube is left here for about 3 months, preventing the closure of the canal during wound healing. It is a closed method. Entering the canal with a 2-diode laser: It is a carbonized method. The device enters the nose like cautery by opening a channel.
Apart from these two methods, there is also the open surgical method, which was used frequently. In this method, a tube is inserted into the nose by opening the skin, subcutaneous tissues and bone tissue from an area between the back and the eye. Since it is an open surgical method, it is not preferred much.