Endoscopic Endonasal Dacryocystorhinostomy Vs LASER-Assisted Dacryocystorhinostomy: Comparative Study

Abstract

Aims: The present study was performed to compare the successful outcomes between endoscopic endonasal dacryocystorhinostomy (EEDCR) and LASER-assisted dacryocystorhinostomy (LDCR).

Subjects and methods:The trial included 50 patients (10-62 years old) who suffered chronic nasolacrimal duct obstruction (CNDO) with no response to conservative and medical measures for several weeks. The patients were divided into two groups according to the surgical intervention used; EEDCR and LDCR (25 patients each). For both EEDCR and LDCR, bicanalicular silicone stents were utilized which were removed from all patients after 4 to 6 months of the interventions. The general-anesthesia-based surgical operations were done in Al-Diwaniyah General Teaching Hospital, Diwaniyah City, Iraq, during the period between February, 2013 to February, 2015.The success of each surgical intervention was decided via the absence of epiphora (subjective) and patency of lacrimal system on irrigation (objective). Follow-up of the patients was continued for 7 to 14 months.

Results: Although the average time spent for the EEDCRsurgery, 38mins, was significantly (p˂0.05) longer than that taken for the LDCR, 25mins, the EEDCR number, 20 (80%), of patients who showed absence of epiphorawas significantly (p˂0.05) higher than that, 16 (64%), from the LDCR patients. On the other hand, 9 (36%) of the LDCR patients significantly (p˂0.05) developed postoperative adhesion, while only 5 (20%) of the EEDCR patients suffered this complication. For surgical revisions, two cases from each group demonstrated full recovery raising the success rate up to 88% and 72% in EEDCR and LDCR, respectively.

Conclusion: Although the time of the surgical operation in the LDCR is lesser than that in the EEDCR, the later represents the most successful surgical intervention to correct chronic nasolacrimal duct obstruction with no response to conservative and medical measures.