At Crystal Vision, we are advocates of restoring the original anatomy. In other words, we aim to restore the duct to the state that nature intended. We do not create new passages or openings for tear drainage, nor do we alter the existing structure.
Regrettably, most surgeons immediately attempt to resolve the issue by removing the lacrimal sac, part of the nasolacrimal duct, or by performing an external operation.
In such a procedure, the lacrimal sac is opened and the lacrimal tissue is drilled fr om the outside. In general, this surgery is invasive, highly traumatic, and not always effective.
Our aim, by contrast, is to fully restore the anatomy of the nasolacrimal duct.
If, for example, due to repeated or incorrect probing, or as a result of nasolacrimal duct atresia or abnormal formation of the duct ostium, we are faced with a situation in which a new nasolacrimal duct must be created, we perform stenting.
The procedure is carried out in collaboration with an ENT specialist.
Using a specialised probe, we pass through the entire nasolacrimal duct. This is performed under video-guided control from the nasal side: a fine camera is introduced into the nose, providing an image on a large screen of the location wh ere the ostium should be. We then map the projection of the entire nasolacrimal duct and gradually advance the probe towards the ostium.
We verify that we have reached the ostium zone and then form it in the anatomically correct manner, so that it functions properly and allows tears to drain through it. Once this formation is complete — having shaped the mucosa, bony frameworks and so on using fine instruments — we need to prevent the duct from closing again.
To achieve this, we introduce a stent into the duct in a specific way, simultaneously through both the upper and lower lacrimal puncta. We leave the stent in place for 2 months to allow the mucosa and nasolacrimal duct to form around it, after which we remove the stent under light anaesthesia, and the child is permanently free of the problem.
