Thulium Laser Dacryocystorhinostomy for Symptomatic Epiphora

Adeo Toti1 popularized the dacryocystorhinostomy (DCR), the gold standard operation for the treatment of obstructive epiphora. Originally, the combination of an external approach to the lacrimal sac and intranasal opening along the lateral nasal wall. Dupuy-Dutemps and Bourguet2 as well as Ohm3 suggested securing mucosal flaps with sutures to help prevent recurrent epiphora. Older4 used silicone tubes to allow the newly stented pathway to heal and prevent re-stenosis.