Fig. 1

Schematic display of primary acquired nasolacrimal duct obstruction treated by laser-assisted dacryocystorhinostomy. a An infrasaccal obstruction of the nasolacrimal duct leads to epiphora. The canaliculi are unobstructed. b A laser fiber is positioned in the lacrimal sac, aiming at the nasal wall to create a nasolacrimal bypass. c After the ostium has been created, tear flow is redirected through the newly formed ostium into the nasal cavity, bypassing the nasolacrimal duct obstruction