In human cadaver specimens, a laser fiberoptic was advanced
through the canalicular systems to create fistulas between the
nasolacrimal sac and nose. A 400- to 600-microns, blunt-tipped
quartz fiberoptic was then advanced through the upper and/or
lower canaliculus to the medial aspect of the nasolacrimal sac.
After 10 to 15 laser pulses (10 W for 0.1 second), a 2.5 x 2.5-mm
fistula was created between the lacrimal sac and the nose just
anterior and inferior to the middle turbinate. Additional laser
pulses can further enlarge the fistula. Endocanalicular laserassisted
dacryocystorhinostomy has potential advantages compared
with endonasal laser-assisted dacryocystorhinostomy, including
the following: laser energy is directed away from the eye; the
technique resembles standard nasolacrimal probing; and nasal
endoscopy and instrumentation may prove unnecessary