Long-Term Outcomes of Transcanalicular Laser Dacryocystorhinostomy Versus Endonasal Dacryocystorhinostomy and a Review of the Literature

Abstract

ABSTRACT Objective: The aim of this study was to compare the efficacy of endonasal dacryocystorhinostomy (EDCR) compared with transcanalicular laser DCR (TL-DCR). Materials and Methods: This retrospective study and systematic review included patients that underwent DCR for nasolacrimal duct obstruction at our tertiary academic care hospital between January 2013 and December 2017. TL-DCR and EDCR were performed on 42 (group 1) and 45 (group 2) patients, respectively. All patients were followed up for a minimum of 4 years after DCR. Success was defined as the complete disappearance of epiphora and the observation of fluid flow without any anatomic obstruction during lacrimal system irrigation. Results: This study included 87 patients who underwent DCR. Fourteen patients (18.7%) were male, and 61 (81.3%) were female. Groups 1 and 2 consisted of 42 and 45 patients who underwent TL-DCR and EDCR, respectively. Success was achieved by 78.5% and 84.4% in groups 1 and 2, respectively. Patients in both groups were followed up for at least 4 years. There was a significant difference in mean surgery time between groups: 33.8 ± 10.5 min vs. 69.9 ± 15.9 min for groups 1 and 2, respectively (P < 0.001). Conclusion: EDCR and TL-DCR without silicone stent have offered a high success rate in the long term. Furthermore, endonasal procedures have less surgery time and leave no scar. We observed that EDCR and TL-DCR are favorable methods in cases of nasolacrimal duct obstruction.