Modified endoscopic DCR without stenting and laser assisted

To evaluate the outcomes of endoscopic LASER assisted dacryocystorhinostomy without stenting, a total of 39 patients (41 eyes) with complains of epiphora and diagnosed with nasolacrimal duct obstruction were included in a prospective study. All the patients had the same preoperative assessment, including radiological and ophthalmologic evaluation, with repeated lacrimal washouts, to confirm the postsacal obstruction. The surgical technique's goal was to create a wide opening of the medial wall of the sac, using drilling of the frontal process of the maxillary bone and some of the lacrimal bone, incision of the lacrimal sac and the radial vaporisation of the incision margins performed with Diode LASER, in order to create a 0.7 - 1 cm opening in the medial wall of the sac. Patients were examined endoscopically, at postoperative intervals of 1 month, 3 month, 6 and 9 month minimum (follow-up period ranged between 9 to 21 months, average 11, 8 months). We obtained a good permeability of the opening of the lacrimal sac in 87.8% of our cases (36 eyes). 5 patients (12.2%) required re-evaluation of the medial sac wall area and re-intervention using different methods. The success criteria were considered the patient's relief of symptoms and the endoscopic visualization of a patent stoma. In conclusions, in the hands of an experienced surgeon, endoscopic LASER assisted dacryocystorhinostomy without stenting compares favourably with other techniques.