Holmium

Lacrimal bypass surgery is the preferred surgical procedure in cases with epiphora, where the canalicular and lacrimal sacral injury is not repairable either by canaliculodacryocystorhinostomy or by conjunctivodacryocystorhinostomy. Accidental and/or surgical trauma being the most common etiology distorts the normal anatomy of the lacrimal drainage system and replaces the normal soft tissue with highly vascularized granulation tissue and eventually fibrosis. Surrounding bony structures may be repaired by callus formation as well, if there is a fracture. These healing changes render the conventional lacrimal bypass surgery difficult to perform. Additional extensive surgical trauma results with additional scar tissue and limited successful outcome. This article describes Holmium:YAG (Ho:YAG) LASER-assisted lacrimal bypass surgery. By means of the hemostatic and less traumatic disruptive properties of Ho:YAG LASER, the surgeon performs an easier, fast, and effective procedure with minimum early and late complications.