A Modern Approach to Lacrimal Surgery

Abstract

In th/s series of 729 lacrimal operations over a ten-year period the techniques of simple and complex lacrimal surgery are discussed. Preoperative investigations included dye tests and radiological studies which determined the type of surgical procedure required. Meticulous haemostasis and identification of the surgical ana tomy reduced the incidence of operative and postoperative complhtions. Where failures occurred re-operation was performed with satisfactory results in all except one case. Lester Jones Pyrex tube techniques are described using a flow system of instrumentation designed to facilitate primary and secondary tube insertion and also tube replacement.

Secondary haemorrhage after dacryocystorhinostomy

“…Some series have reported much lower rates: from less than 0.5%. 4,5,10,12–14 to 1% 15–17 . Tarbet & Custer 11 reported secondary haemorrhage in 3.9% (6/153) of DCR and identified risk factors in three.…”

“…Some authors have speculated that tears may have a fibrinolytic effect in patients with subtle blood dyscrasias. 12 Bartley & Nichols 9 reported two patients from 150 who suffered a secondary haemorrhage. Both of these patients had platelet dysfunctions but no thrombocytopenia.…”