Lacrimal sac stones
This is Richard Allen at the University of Iowa. This video demonstrates a few examples of lacrimal sac stones. The first shows bilateral lacrimal sac stones in a patient who is undergoing a bilateral dacryocystorhinostomy. The lacrimal sac is opened on the right with the 66 Beaver blade. In doing this, a stone is identified and removed from the lacrimal sac. The procedure is then performed on the left side where again another stone is identified. I think that it is important to inspect the inside of the lacrimal sac when we perform dacryocystorhinostomies to identify any potential stones. They should be removed if encountered.
In the second video, the lacrimal sac is again opened with a Beaver blade. The inside of the sac is inspected and a large stone is noted in the sac. This is removed and the sac is inspected further. An associated pyogenic granuloma is also noted.
In the last case, the medial portion of the lacrimal sac is noted, and the sac is opened with the Beaver blade. An anterior flap is fashioned with the Beaver blade. The inside of the sac should always be inspected. In doing so, a lacrimal sac stone is noted. An additional piece of stone is noted superiorly and is removed as well.
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