A simple and efficient technique for suturing and knotting during endoscopic dacryocystorhinostomy

Area of Science:

• Ophthalmology
• Surgical Innovation
• Lacrimal System Surgery

Background:

• Nasolacrimal duct obstruction (NLDO) significantly impacts quality of life.
• Traditional dacryocystorhinostomy often involves stents or adjunctive medications like mitomycin C.
• Minimally invasive endoscopic techniques are evolving for DCR.

Purpose of the Study:

• To evaluate the long-term outcomes of endoscopic suturing and knotting-dacryocystorhinostomy (eSK-DCR).
• To assess the efficacy of eSK-DCR performed without stents or mitomycin C.
• To determine the anatomical and functional success of this technique over a 2-year period.

Main Methods:

• A prospective interventional case series of 60 patients with NLDO.
• Patients underwent endoscopic DCR with suturing of lacrimal and nasal mucosa (eSK-DCR).
• Data collected included surgical parameters, Munk scores, and 2-year follow-up for anatomical and functional success.

Main Results:

• 100% anatomical success (patent ostium) and 87.5% functional success at 2 years.
• Significant reduction in Munk scores postoperatively (P < 0.0001).
• All patients showed patent ostium and normal healing by 4 weeks, with stable outcomes.

Conclusions:

• Pure eSK-DCR is a simple, reliable, and effective treatment for NLDO.
• The technique avoids the need for stents and mitomycin C.
• Good surgical outcomes are maintained long-term, beyond 6 months postoperatively.