Comparison of Anatomical and Symptomatic Success in Transcanalicular Laser Dacryocystorhinostomy

OpenAlex · İngilizce

Objective: Nasolacrimal duct obstruction (NLDO) patients who underwent Transcanalicular dacryocystorhinostomy (TC-DCR) were retrospectively analyzed to determine surgical success using anatomical and symptomatic outcomes. Material and Methods: Patient files for patients who were treated for NLDO with TC-DCR between 2012-2013 at Balikesir University Hospital were examined and 43 patients were included in the study. Surgical and symptomatic success were evaluated. Patients symptoms, patient satisfaction, epiphora scoring and detailed opthalmological examination findings were recorded. Anatomical success was defined by a patent nasolacrimal lavage and symptomatic success was defined by patients satisfaction and using Sahlin's epiphora score. Results: In our study anatomical success at the last examination was 82.2%. 26.5 % of patients had severe epiphora (grade 2 and grade 3). Leaving our symptomatic success rate at 73.5%. Epiphora is the main presenting complaint of patients with nasolacrimal duct obstruction (NLDO). Historically external dacryocystorhinostomy (EX-DCR) has been considered the gold standard treatment of NLDO, however in the last decade transcanalicular and endonasal approaches have gained popularity. As transcanalicular dacryocystorhinostomy (TC-DCR) is less invasive than EXDCR what remains is to achieve the success rates of EX-DCR procedures. Surgical success can be defined by anatomical patency and patient satisfaction. Persistent epiphora in external DCR patients despite anatomical patency may be due to damage to the lacrimal pump system; this together with greater symptomatic relief in TC-DCR could be a reason to consider transcanalicular surgery as superior to external DCR. Conclusion:We feel that transcanalicular procedures may be advantageous in epiphora scoring and symptomatic findings compared to EX-DCR.