Endoscopic Dacryocystorhinostomy (DCR): a comparative study between powered and non-powered technique.

Area of Science:

• Ophthalmology
• Otorhinolaryngology
• Surgical Innovation

Background:

• Nasolacrimal duct obstruction is commonly treated with dacryocystorhinostomy (DCR).
• Endoscopic DCR offers minimally invasive approaches, with powered drills and kerrison punches being common instruments.
• Evidence comparing the clinical outcomes and operative details of these two endoscopic tools is limited.

Purpose of the Study:

• To compare the efficacy and safety of endoscopic dacryocystorhinostomy (DCR) using a kerrison punch versus a powered drill.
• To evaluate differences in operative time, success rates, and complication profiles between the two techniques.

Main Methods:

• Retrospective chart review of 59 patients undergoing endoscopic DCR between June 2013 and July 2014.
• Comparison of operative details, surgical outcomes, and complications between 34 patients who had kerrison punch DCR and 32 patients who had powered drill DCR.

Main Results:

• A total of 66 procedures were analyzed.
• Success rates were comparable: 87.88% for kerrison punch and 90.9% for powered drill (p=0.827).
• Complication rates were not significantly different (p=0.91), but operative time was significantly shorter with the kerrison punch (75 min vs. 125 min, p=0.0001).

Conclusions:

• Endoscopic DCR with a kerrison punch demonstrates a significant reduction in operative time compared to using a powered drill.
• Both techniques yield comparable success rates and complication profiles for treating nasolacrimal duct obstruction.
• The kerrison punch may be a more time-efficient option for endoscopic DCR without compromising outcomes.