Comparison of transcanalicular diode laser dacryocystorhinostomy and external dacryocystorhinostomy in patients with primary acquired nasolacrimal duct obstruction

Aims and Objectives: To compare the success rates of non endoscopic endonasal dacryocystorhinostomy and conventional external dacryocystorhinostomy for the surgical management of primary acquired nasolacrimal duct obstruction. Materials and methods: A retrospective, nonrandomized, comparative interventional case series of 302 patients who underwent either endonasal or external dacryocystorhinostomy over a period of 2 years. All surgeries were performed by a single surgeon and patients with primary nasolacrimal duct obstruction with a minimum of 6 months post operative follow up were included in the study. While external dacryocystorhinostomy was performed using traditional technique, endonasal dacryocystorhinostomy was performed using direct method of nonendoscopic visualization. Results: Of the 302 cases included in the study 165 patients had endonasal dacryocystorhinostomy whereas 137 underwent external dacryocystorhinostomy. Success was defined by resolution of symptoms of tearing, a negative fluorescein dye disappearance test and patency of the canalicular system on lacrimal irrigation. In the external dacryocystorhinostomy group 124 (90.5%) patients had surgical success whereas 146 (88.5%) of the endonasal dacryocystorhinostomy patients had successful outcome. The overall success rate was 89.4%, and the difference of surgical success between the two groups was not statistically significant ( P=0.57). Conclusion: Non endoscopic endonasal dacryocystorhinostomy gives surgical results comparable to those of external dacryocystorhinostomy and is a viable alternative where dacryocystorhinostomy is indicated for primary acquired nasolacrimal duct obstruction. Key words: Endonasal Dacryocystorhinostomy (ENDCR), External Dacryocystorhinostomy (EXDCR), Primary acquired nasolacrimal duct obstruction (PANLDO) doi: 10.3126/kumj.v6i4.1731 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 437-442

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External dacryocystorhinostomy

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v16i3.510 ◽

2019 ◽

Vol 16 (3) ◽

pp. 179-185

Author(s):

Li Ying Long ◽

Safinaz Mohd Khialdin ◽

Nazila Binti Ahmad Azli

Keyword(s):

Surgical Technique ◽

Success Rate ◽

Case Series ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Retrospective Case ◽

Duct Obstruction ◽

Posterior Flap ◽

External Dacryocystorhinostomy ◽

External Dcr

Aim: To analyse the epidemiological data, surgical technique, success rate, and complications of patients who underwent external DCR in Hospital Selayang from January 2015 to December 2016. Method: Retrospective case series. Results: A total of 21 eyes of 20 patients who underwent external DCR from January 2015 to December 2016 were identified and reviewed. There were 15 females (75%) and 5 males (25%). Age ranged from 5 to 75 years old, with a median age of 56 years old (IQR 23). Twelve patients presented with epiphora while eight patients presented with symptoms of dacryocystitis. One case was congenital, two were secondary nasolacrimal duct obstruction and the rest were primary nasolacrimal duct obstruction. All patients underwent external DCR under general anaesthesia. Silicone tube were inserted in 21 eyes, of which all were removed 3 months after the surgery except one patient whom had his tube dislodged accidentally. The overall success rate was 90.5% (n = 19), which was defined as no or minimal intermittent epiphora or no reflux on lacrimal irrigation at 12 months postoperative. There was one patient who had a cerebrospinal fluid leak treated successfully with intravenous antibiotics. Conclusion: The surgical success rate for external dacryocystorhinostomy was comparable to that of the global success rate of external DCR. This is attributed to the application of surgical technique such as anterior suspended flap modification and posterior flap excision.

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A clinical trial of endoscopic vs external dacryocystorhinostomy for partial nasolacrimal duct obstruction

Eye ◽

10.1038/eye.2011.77 ◽

2011 ◽

Vol 25 (9) ◽

pp. 1219-1224 ◽

Cited By ~ 14

Author(s):

F H Zaidi ◽

S Symanski ◽

J M Olver

Keyword(s):

Clinical Trial ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

External Dacryocystorhinostomy

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Outcomes of external dacryocystorhinostomy and endoscopic endonasal dacryocystorhinostomy in the management of nasolacrimal duct obstruction

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v7i1.13165 ◽

2015 ◽

Vol 7 (1) ◽

pp. 39-46 ◽

Cited By ~ 3

Author(s):

S Duwal ◽

R Saiju

Keyword(s):

Success Rate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Endoscopic Endonasal ◽

Duct Obstruction ◽

Dence Interval ◽

External Dacryocystorhinostomy ◽

Group 2 ◽

External Dcr ◽

Group 1

Introduction: Dacryocystorhinostomy (DCR) is the treatment of choice for nasolacrimal duct obstruction. Although external DCR is regarded as the gold standard, endoscopic DCR is evolving as an equally-effective alternative. Objectives To compare the success rate of treating nasolacrimal duct obstruction by endoscopic endonasal method compared to the conventional DCR surgery.Materials and methods This prospective, comparative, non-randomised study was conducted in 2009 - 2010. Thirty consecutive patients undergoing endoscopic endonasal DCR (Group 1) and 30 consecutive patients undergoing external DCR (Group 2) between July 2009 and September 2010 at the oculoplasty unit of the Tilganga institute of ophthalmology were included in this study. A patent lacrimal passage on syringing and symptomatic improvement at six months after surgery was de¿ned as a successful outcome. The intraoperative and postoperative complications were also compared. Results Our study included 31 eyes of 30 patients in Group 1 and 34 eyes of 30 patients in Group 2. The success rate for endoscopic endonasal dacryocystorhinostomy was 90.3 % (95 % con¿dence interval 80 - 100) and external dacryocystorhinostomy was 94.1 % (95 % con¿dence interval 80 - 100). The difference of surgical success among the two methods was not statistically significant (p = 0.7). The rate of intra-operative and post-operative complications was similar in the two methods (p = 0.5). Conclusion: The short term outcomes and complication rates of endoscopic endonasal dacryocystorhinostomy and external dacryocystorhinostomy were similar.

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External Dacryocystorhinostomy with Silicone stent in Anatomical and Functional primary acquired nasolacrimal duct obstruction

IP International Journal of Ocular Oncology and Oculoplasty ◽

10.18231/j.ijooo.2020.026 ◽

2020 ◽

Vol 6 (2) ◽

pp. 122-128

Author(s):

Vasu Narasimha Naik ◽

◽

Kumar V

Keyword(s):

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Silicone Stent ◽

External Dacryocystorhinostomy

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ENDOSCOPIC ENDONASAL DACRYOCYSTORHINOSTOMY: EXPERIENCE OF HUNDRED CASES

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i6.4251 ◽

2021 ◽

Vol 71 (6) ◽

pp. 2104-08

Author(s):

Muhammad Shahid ◽

Muhammad Awais ◽

Amjad Akram ◽

Syed Abid Hassan Naqvi ◽

Omar Zafar ◽

...

Keyword(s):

Armed Forces ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Sample Population ◽

Endoscopic Endonasal ◽

Duct Obstruction ◽

Lacrimal System ◽

Chronic Dacryocystitis ◽

Quasi Experimental ◽

External Dacryocystorhinostomy

Objective: To determine the success rate of Endonasal Endoscopic Dacryocystorhinostomy (Endo-DCR) in cases of chronic dacryocystitis secondary to primary acquired nasolacrimal duct obstruction (NLDO). Study Design: Quasi-experimental study. Place and Duration of Study: Department of Oculoplastic Surgery, Armed Forces Institute of Ophthalmology Rawalpindi, from Sep 2018 to Nov 2019. Methodology: Endo-DCR under General Anaesthesia was performed on 100 patients of primary acquired nasolacrimal duct obstruction causing chronic dacryocystitis. Post-operatively these patients were checked on first post-op day, then on one week and finally four months after surgery. We removed silicone tubes of all the patients four months after surgery. To ensure patency of lacrimal passage, we did syringing and irrigation of lacrimal system of all cases, at conclusion of the study. We chose absence of epiphora and patent lacrimal system on syringing as indicators of successful procedure. Results: Hundred patients (males 37; females 63) were recruited for this study. Mean age of our sample population was 51.1 ± 29 years. Right nasolacrimal duct obstruction cases were 56 whereas left nasolacrimal duct obstruction cases were 44. Subjective improvement i.e., absence of epiphora was found in 90% patients. We got successful irrigation of lacrimal passages (objective improvement) in 94% of patients. Conclusion: Endo-DCR yields comparable results to external Dacryocystorhinostomy (Ex DCR). It offers additional benefits of esthetically better outcome, lesser complication rate and short surgery and patient recovery time.

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