Dye-Enhanced Argon Laser Canaliculoplasty: Review of Underused Procedure for Dry Eye
Purpose
At ASCRS 2014 the paper Dye Enhanced Argon Laser Punctum Stenosis (DEALPS) created considerable interest and some confusion. DEALPS was introduced as a new procedure without presenting specific surgical parameters. This paper will review DEALPS history and a step wise more efficient surgical procedure to close both punctum and the canaliculus.
Methods
The Original Herrick Laser Canaliculoplasty (HLC) was modified as follows: -Topical plus Local anesthesia in the medial lid area. -Blue dye is placed over the punctum. -Apply four laser spots (50mc/200mw) creating a square around the punctum. -Connect the four laser spots ablating deeply and creating a trench around a heat sink. -Apply laser (200mc/200mw) inside the square to obliterate the vertical canniculus and puncta. -An antibiotic ointment is applied over each treatment area.
Results
The new Dye Enhanced Argon Laser Canniculuoplasty (DEALC) technique decreased the surgery time from fifteen minutes to five minutes; plus closed th epunctum and canaliculus with a precise treatment endpoint without relying on a visual endpoint as in HLC. Decreased surgery time was more comfortable for patients.
Conclusion
DEALC decreases surgery time by ten minutes per lid and is more comfortable for the patient. The new technique closes the puncta and superior vertical canniculus while providing a definite endpoint, decreases laser wear and tear, averts punctal plug complications and cost, plus it is reversible.