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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
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Transconjunctival dacryocystorhinostomy: Long term results
Pelin Kaynak1, Can Ozturker1, Gamze Karabulut1
1Ophthalmic Plastic and Reconstructive Surgery Department, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34349 Istanbul, Turkey.
Summary
Transconjunctival dacryocystorhinostomy (TRC-DCR) offers a scarless approach for epiphora due to PANDO, achieving a 92.5% success rate comparable to external DCR at two years. This technique avoids major complications, making it a viable alternative for nasolacrimal duct obstruction treatment.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Lacrimal System Disorders
Background:
- Primary acquired nasolacrimal duct obstruction (PANDO) causes epiphora, significantly impacting quality of life.
- Traditional dacryocystorhinostomy (DCR) techniques can leave visible scars.
- Transconjunctival dacryocystorhinostomy (TRC-DCR) aims to provide a scarless surgical alternative.
Purpose of the Study:
- To evaluate the functional and anatomical outcomes of transconjunctival dacryocystorhinostomy (TRC-DCR) for primary acquired nasolacrimal duct obstruction (PANDO).
- To assess the success rate of TRC-DCR at the second year follow-up.
- To compare the outcomes of TRC-DCR with external DCR.
Main Methods:
- Retrospective, interventional study including 33 eyes of 29 patients with PANDO.
- TRC-DCR performed via an inferomedial lower eyelid conjunctival incision.
- Surgical time, intraoperative difficulties, complications, and follow-up (average 2 years) were recorded. Anatomical success defined by patent passages; functional success by epiphora relief.
Main Results:
- TRC-DCR was completed in 27 eyes (81.8%); 6 eyes (18.2%) were converted to external DCR.
- Successful epiphora resolution in 92.5% of completed TRC-DCR cases at two years.
- One case required reoperation; granuloma formation occurred in 11.1% of eyes. External DCR achieved 100% epiphora resolution.
Conclusions:
- Transconjunctival dacryocystorhinostomy (TRC-DCR) is an effective scarless technique for PANDO.
- Success rates at two years are comparable to external DCR.
- TRC-DCR demonstrates a favorable safety profile with no major complications.
