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Updated: Jul 16, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Lacrimal drainage obstruction and dacryocystorhinostomy in children
A Y Nemet1, A Fung, P A Martin
1Oculoplastic unit, Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital, Sydney, New South Wales, Australia. nemeta@yahoo.com
Insights
Dacryocystorhinostomy (DCR) for pediatric nasolacrimal duct obstruction (NLDO) shows good results. Silicone intubation reduces revision rates compared to Jones tubes or no stent in DCR surgery.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Nasolacrimal duct obstruction (NLDO) is a common condition in children.
- Dacryocystorhinostomy (DCR) is a surgical procedure to restore tear drainage.
Purpose of the Study:
- To evaluate the outcomes of DCR in pediatric patients with NLDO.
- To compare complication rates and revision needs between different DCR techniques.
Main Methods:
- Retrospective review of 104 DCR cases (82 patients) at Sydney Eye Hospital (1995-2004).
- Assessed outcomes including symptomatic relief, complications, scar visibility, and patient satisfaction.
- Statistical analysis using chi-squared and Student's t-tests.
Main Results:
- 94 external DCR, 10 endoscopic DCR, and 5 revision procedures were analyzed.
- Complications were mainly associated with Jones tube placement in external DCR.
- Silicone intubation significantly reduced the need for revision surgery compared to non-stented or Jones tube groups.
Conclusions:
- External DCR offers acceptable long-term clinical and cosmetic outcomes with a low complication rate.
- Punctal stenosis or Jones tube use increases complication risk.
- Silicone intubation is associated with a lower revision rate in pediatric DCR.
Purpose:
To determine the outcome of dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction (NLDO) in children.
Methods:
A review of medical records of 104 cases (82 patients) of paediatric DCR who underwent DCR at the Sydney Eye Hospital from 1995 to 2004. The main outcome measures included post-operative symptomatic relief of presenting symptoms, complications, subjective visibility of any scar, and general satisfaction. Statistical methods included chi(2) tests, and Student's t-tests for the comparison of variables among groups.
Results:
Ninety-four external, 10 endoscopic primary procedures, and five revision procedures were included. Fifty-six of the cases were primary NLDO, and 48 were secondary NLDO. The mean follow-up was 1.44 years. Average age at surgery was 6.6+/-4.2 years (mean+/-SD). Ninety-one eyes needed DCR for the involvement of the lower lacrimal outflow system, and 13 eyes were NLDO associated with congenital punctual/canalicular dysgenesis.Most of the complications of external DCR were related to Jones tube placement. Five cases (4.8%) needed DCR revision. There was a significantly higher incidence of revision surgery in the non-stented group (P<0.01), and the Jones tube group (P<0.001) as compared with the silicone intubation stent group.
Conclusions:
External DCRs have acceptable long-term clinical and cosmetic results, and low post-operative complication rate. Cases with punctal stenosis or those requiring Jones tube insertion are associated with a higher complication rate. Silicone intubation is associated with a lower need for operative revision.
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