Note: Irrigation of the nasolacrimal duct may be sufficient for acquired nasolacrimal duct obstruction!
1st order
- Dilation (stretching) – in the case of lacrimal punctal or canaliculus stenosis.
- Dacryocystorhinostomy (synonym: Toti surgery): surgical creation of a connection between the lacrimal sac and the nasal cavity to restore the flow of tears from the lacrimal sac into the nose when the nasolacrimal duct is nonfunctional
- Advantage: surgery can be performed externally or endoscopically
- Indications: for narrowed or occluded lacrimal ducts (lacrimal duct stenosis).
- Ultima Ratio therapy (last diagnostic option to still make progress in the treatment of the disease).
- Toti surgery has a success rate between 90% to 95%.
- Lacrimoplasty: is used to expand the superficially located lacrimal puncta.
- Indications: Narrowing of the openings of the lacrimal duct tubules.
