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Updated: Jan 6, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Outcomes of dacryocystorhinostomy with or without stent Insertion-A systematic review and Meta-analysis
Tzu-Tang Lin1, Chih-Hao Liu1, Yu-Ming Hsu2
1School of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
Purpose:
To evaluate whether stent placement improves the surgical success of dacryocystorhinostomy (DCR), considering different approaches and stenting durations.
Methods:
We conducted a systematic search of PubMed, Embase, Cochrane Library, and Web of Science for randomized controlled trials (RCTs) comparing DCR with and without stent insertion. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using the Mantel-Haenszel (MH) fixed-effect model, as heterogeneity was negligible (I²<0.1%). Subgroup analyses were conducted to compare surgical approach (external, endoscopic, and laser-assisted) and stenting duration (≤ 6 weeks vs. >6 weeks). Heterogeneity was assessed using Cochran's Q and I² statistics. Sensitivity analysis and publication bias were also evaluated.
Results:
Eighteen RCTs involving 1,517 patients were included. The meta-analysis demonstrated that stent placement significantly improved the DCR success rate compared to non-stented DCR (OR = 1.691; 95% CI: 1.196-2.391; p = 0.003). The average success rates were 92.6% and 88.2% in the stented and non-stented groups, respectively. Subgroup analysis showed significantly better outcomes in external DCR with stenting but not in endoscopic DCR. A shorter stenting duration (≤ 6 weeks) also showed significant benefit over non-stented procedures, whereas longer duration (> 6 weeks) did not. Heterogeneity was low (I²<0.1%), and sensitivity analysis confirmed the robustness of the findings.
Conclusions:
Stented DCR significantly enhanced surgical success in external approaches, while internal approaches lack significant difference and evidence for laser-assisted DCR remains limited. Also, a shorter stenting duration appears to be associated with a higher success rate while potentially minimizing complications according to prior evidence, although the optimal duration remains uncertain. Further research is needed to clarify the efficacy of stenting in laser-assisted DCR.
