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Updated: Mar 19, 2026
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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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Office-based endoscopic revision using a microdebrider for failed endoscopic dacryocystorhinostomy
1Department of Ophthalmology, Dongguk University Gyeongju Hospital, 87 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do, 780-350, South Korea.
Summary
Office-based revision endoscopic dacryocystorhinostomy (EN-DCR) using a microdebrider effectively treats failed primary surgeries. This minimally invasive approach offers a high success rate for relieving epiphora, making it a time- and cost-effective option.
Area of Science:
- Ophthalmology
- Otolaryngology
- Minimally Invasive Surgery
Background:
- Endoscopic dacryocystorhinostomy (EN-DCR) can fail due to cicatrization, granuloma, or synechia.
- Persistent epiphora after primary EN-DCR necessitates revision surgery.
Purpose of the Study:
- To evaluate the efficacy and safety of office-based revision EN-DCR using a microdebrider.
- To assess the anatomical and functional outcomes of this minimally invasive revision technique.
Main Methods:
- A retrospective analysis of 27 eyes from 24 patients undergoing office-based revision EN-DCR with a microdebrider.
- Local anesthesia was used, followed by microdebrider-assisted revision and bicanalicular silicone tube intubation.
- Outcomes were evaluated at 6 months post-revision.
Main Results:
- The primary causes of failure were rhinostomy site cicatrization (63.0%), granulomatous obstruction (25.9%), and synechia (11.1%).
- 100% anatomical success and 85.2% complete relief of epiphora were achieved.
- Surgery averaged under 10 minutes with no observed complications.
Conclusions:
- Office-based revision EN-DCR with a microdebrider is a safe and effective treatment for failed primary EN-DCR.
- This approach offers prompt management of post-DCR epiphora, is time- and cost-saving, and can be performed with office staff.
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