COMBINED USAGE OF NEODYMIUM YAG 1.44 ΜM AND HELIUM-NEON LASERS IN LACRIMAL APPARATUS SURGERY
A novel technique based on simultaneous action of two types of laser radiation conducted with the same optical fiber for surgical treatment of lacrimal apparatus was proposed. The laser endodissector (neodymium YAG 1.44 μm) unblocks lacrimal outflow pathways. Helium-neon laser operates in continuous mode, activates the regeneration process of damaged tissues, has anti-inflammatory (phototherapeutic) effect on the inside of mucosa lining lacrimal apparatus, serves as an optical fiber, besides that, it’s a marker for operating in the pulsed mode of colorless, destroying energy of Nd-YAG laser. We operated 60 patients with the diagnosis of obliteration of nasolacrimal canal, dacryocystitis, chronic rhinitis in remission stage. The patency of lacrimal passages was restored. Complications during the surgery and in the postoperative period were not observed. In the long-term period (6-18 months) in 53 cases (88%) lasting positive effect took place. In two cases lacrimation was noticed at forward flexion of head due to atony of the lower eyelid. Relapse of inflammation was observed in 7 patients with both rhinitis and conjunctivitis. The combined application of two types of laser energy of different target impact, performed by one optical fiber for photodisruption (Nd-YAG 1.44 μm) and phototherapeutic effect using low-intensity helium-neon laser can reduce postoperative recovery period due to the leveling of concomitant inflammatory pathology and the activation of regenerative processes.