Principles and Practice of Lacrimal Surgery

384 Pages·2015·35.2 MB·English

by  Mohammad Javed Ali (eds.)

Principles and
Practice of
Lacrimal Surgery
Mohammad Javed Ali
Editor
123
Principles and Practice
of Lacrimal Surgery

Mohammad J aved Ali
Editor
Principles and Practice
of Lacrimal Surgery
Editor
Mohammad Javed Ali, MS, FRCS, FRCGP
Dacryology Service
L.V. Prasad Eye Institute
Hyderabad
India
ISBN 978-81-322-2019-0 ISBN 978-81-322-2020-6 (eBook)
DOI 10.1007/978-81-322-2020-6
Springer New Delhi Heidelberg New York Dordrecht London
Library of Congress Control Number: 2014952330
© Springer India 2015
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Dedicated to my family – Dawood Ali, Qaiser Yasmeen,
Farhana Baig, Majid Ali, Rehana Ali, Hafsa Javed, Nabiha
Khan, and Jibran Ali
Dedicated to all my mentors and all my patients

Foreword
O ver the last 25 years, the lacrimal system has received increasing interest
both from the oculoplastic and sinus surgeons. Traditionally, the lacrimal sys-
tem has been approached through a medial canthal external incision. In the
best hands of trained Oculoplastic surgeons, this technique has excellent
results. The revival in interest in approaches to the lacrimal system has been
driven by the development of the endoscope and increasingly better digital
camera systems that allow the anatomy to be both magnifi ed and displayed in
crisp detail facilitating delicate and precise surgery. This move in lacrimal
surgery mirrors the general surgical move from incisions to minimally inva-
sive surgery with the endoscope playing the central role in this surgical
evolvement. The interest in the endoscopic techniques has increased espe-
cially among oculoplastic surgeons, as the results with this technique are now
at least equivocal and in some publications better than the traditional external
techniques.
T his book provides an extraordinarily comprehensive reference, starting
with historical perspectives, anatomy, and assessment and then going through
the many and varied external approaches before moving to an extensive guide
on the endoscopic approaches. Finally, an overview of quality of life in lacri-
mal disorders is provided. The list of contributors is impressive as is their
expertise in the chapters which they provide. Worthy additions to the text are
a number of chapters on controversial topics in lacrimal surgery, such as the
role of mitomycin C, whether the lacrimal system should be routinely intu-
bated after DCR surgery, and the management of common canaliculus
strictures.
T his text is wide ranging and extensive and covers established knowledge,
new ideas, and controversies presented by high-quality contributors with
insight and experience and as recognized experts in the fi eld. This book
would be a worthy addition to the library of any surgeon interested in lacrimal
surgery, allowing them to delve quickly into chapters for valuable insights as
well as having it as a major reference text resource. This book is the most
valuable contribution to our literature, and the editor and contributing authors
are to be congratulated.
Adelaide , SA , Australia Peter-John Wormald
vii

Prol ogue
Lacrimal Surgery: Glorious Past, Exciting Present Era,
and the Audacity of Hope for a Brilliant Future
D o not fear to be eccentric in opinion, for every opinion now accepted was once
eccentric. – Bertrand Russell (1872–1970)
The evolution of lacrimal disorders and their management amply exemplifi es
the above stated quote of the twentieth-century British philosopher Bertrand
Russell. Lacrimal surgeries has been a subject of discussion in antiquity with
the earliest documented reference being a lacrimal sac incision in the “Code
of Hammurabi” in 2250 BC [1]. The past which appears glorious today had
once travelled through many rough terrains in ancient times nurtured by the
Egyptians (Ebers Papyrus – 1500 BC), the Greeks (Hippocrates and Celcus –
25 BC), and the Romans (Galen – 200 AD) [1, 2]. The Arabians chipped in
between with their contributions from Ibn Sina and Al Razi in the medieval
times. The Modern Dacryology was given impetus with the hallmark
anatomical works of Giovanni Morgagni (1682–1771) and Johann Zinn
(1727–1759) and equally by the infl uential lacrimal treatises by Percival Pott
(1714–1788) and Johann Schmidt (1759–1809) [3].
“Men love to wonder and that is the seed of science,” said the famous
nineteenth-century American poet Ralph Waldo Emerson. Lacrimal surgeries
have undergone a sea change in the last two centuries. The original Woolhouse
technique (1724) of dacryocystectomy underwent numerous changes in tech-
niques and approaches to the present age but with progressively lesser indica-
tions. The external dacryocystorhinostomy (DCR) had a steeper evolution for
obvious reasons from the times when Addeo Toti (1904) fi rst described it to
the current-day practice with various incisions and lacrimal sac implants [4,
5]. With the introduction of rigid endoscopy and better view, endonasal dac-
ryocystorhinostomy showed a steep resurgence into the practice (McDonough
−1989) [6], more than a century after its original description (Caldwell –
1893) [7] failed to gain wider acceptance. Endocanalicular laser DCR, how-
ever, till the present date has failed to gain widespread acceptance despite
numerous modifi cations since its introduction to dacryology by Levin and
Stormogipson in 1992 [8, 9]. Likewise was the journey of trans-conjunctival
DCR (CDCR), which evolved into endoscopic and lesser invasive approaches
along with numerous Jones tube modifi cations [10, 11]. Balloon dacryoplasty
ix