Outcome comparison between transcanalicular and external dacryocystorhinostomy

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Nasolacrimal duct obstruction (NLDO) affects tear drainage, impacting quality of life.
• Surgical interventions like dacryocystorhinostomy aim to restore patency.
• Comparing different surgical approaches is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the efficacy of external dacryocystorhinostomy (EX-DCR) and transcanalicular dacryocystorhinostomy (TC-DCR) using a multidiode laser.
• To evaluate both objective and subjective outcomes in patients with bilateral NLDO.

Main Methods:

• A prospective study involving 19 patients (38 eyes) with bilateral NLDO.
• Simultaneous bilateral surgery: TC-DCR with diode laser in the right eye, EX-DCR in the left eye.
• Postoperative assessment included objective lacrimal system irrigation and subjective symptom evaluation (tearing, irritation, pain, discharge, VAS score) at multiple intervals up to 12 months.

Main Results:

• EX-DCR demonstrated a significantly higher objective success rate (89.5%) compared to TC-DCR (73.7%) at 12 months.
• No significant differences were observed in subjective outcomes like tearing, pain, or irritation between the two groups.
• Higher discharge scores were noted in the TC-DCR group, while visual analogue scale (VAS) scores showed no significant difference.

Conclusions:

• While transcanalicular dacryocystorhinostomy (TC-DCR) offers a minimally invasive approach, external dacryocystorhinostomy (EX-DCR) yields superior objective and subjective outcomes.
• EX-DCR may be the preferred surgical option for achieving better long-term results in nasolacrimal duct obstruction management.