Endocanalicular laser dacryocystorhinostomy analysis of 118 consecutive surgeries

To describe the outcomes of endocanalicular laser dacryocystorhinostomy (ECL DCR) for patients with nasolacrimal duct obstruction (NLDO).

Retrospective, noncomparative, interventional case series.

One hundred eight consecutive patients who underwent ECL DCR.

The records of the patients who underwent ECL DCR at 1 of 2 academic centers were reviewed and the data analyzed.

Success was defined as the resolution of symptoms or unobstructed lacrimal irrigation.

One hundred eighteen consecutive ECL DCR surgeries performed on 108 patients between June 1997 and June 2003 were reviewed, excluding 6 lost to follow-up. Endocanalicular laser DCR was the initial surgical intervention for all cases except 6 that had previously undergone surgery (external or endonasal DCR) at outside hospitals. Twenty-seven of the surgeries were considered failures on the basis of recurrent epiphora or discharge, or reflux on nasolacrimal irrigation. One of the failures was permanently corrected with balloon dacryoplasty. Nine of the other failures had a repeat procedure, with 7 remaining patent after one repeat procedure and an additional one remaining patent after a third procedure. All 6 ECL DCR procedures that were performed after external or endonasal DCR at an outside institution remained patent. Among the 102 initial lacrimal surgeries in this series, there was a 73.6% success rate. The overall success, including repeat procedures, was 81.5%. The success of this technique as a repeat procedure after previous external, endonasal, or ECL DCRs was 87.5%.

Endocanalicular laser DCR offers a minimally invasive alternative procedure for the treatment of NLDO. In our series, the success rates are comparable to those previously reported. The technique had a high success rate when used to treat recurrent NLDO after previous lacrimal surgery.