Endoscopic Dacryocystorhinostomy (DCR) Revision

This video demonstrates an endoscopic revision of an external dacryocystorhinostomy (DCR) that was performed at an outside institution. Dr. Watson uses a lacrimal probe to identify the region of the previous osteotomy and ensure that the common canaliculus is carefully protected. She performs a fresh mucosal incision then uses a periosteal elevator to lift the mucosa off of the previous osteotomy. She then removes scar tissue and neo-bone to optimize the size of the osteotomy and clear any scar tissue obstructing the opening. The lacrimal sac was previously opened and excised. She places probes through the upper and lower canalicular systems to identify the common canaliculus and confirm adequate opening. The canalicular system then can be intubated.