Instrumentation

grade approach. Meanwhile special low-profile dac-ryocystoplasty catheters have been designed allowing safe balloon dilation performed antegradely using the transcanalicular access (Wilhelm et al. 2000); therefore, no further nasal manipulation is necessary resulting in greater patient comfort and acceptance of the procedure. We prefer to use 2-mm balloon diameter for obstructions of the canaliculi and 3 mm for obstructions of the nasolacrimal duct and sac. The inflation pressure routinely applied to reach complete balloon inflation is about 10 bar. The duration of inflation of the balloon catheter ranges from 20 min to 15 s (Song 2002). We emphasize that the balloon catheter should be inflated for a short time, to prevent severe damage to the lacrimal drainage system and the surrounding structures, especially the venous plexus (Wilhelm et al. 1999).

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