Endoscopic holmium:YAG laser dacryocystorhinostomy

Area of Science:

• Ophthalmology
• Otolaryngology
• Laser Surgery

Background:

• Nasolacrimal duct obstruction causes significant discomfort and visual impairment.
• Conventional dacryocystorhinostomy (DCR) is an established surgical treatment.
• Endonasal laser techniques offer potential advantages in minimally invasive surgery.

Purpose of the Study:

• To present early results of primary endonasal laser dacryocystorhinostomy (ELDC) using the holmium:YAG laser.
• To evaluate the efficacy and patient acceptance of ELDC compared to conventional DCR.

Main Methods:

• Retrospective analysis of 50 primary endonasal laser dacryocystorhinostomies in 49 patients using holmium:YAG laser.
• Comparison with a retrospective study of 67 patients undergoing conventional DCR.
• Data collection included success rates, follow-up duration, anesthesia type, inpatient/outpatient status, surgery time, and patient satisfaction.

Main Results:

• Overall success rate for ELDC was 70% (35/50 patients) after a 4-month follow-up.
• Success rate improved to 79% in patients with nasolacrimal intubation.
• ELDC procedures were significantly quicker, performed under local anesthesia, and predominantly as outpatient surgery (94%).
• Patient satisfaction with ELDC was high (90%).

Conclusions:

• Endonasal laser dacryocystorhinostomy with holmium:YAG laser is a viable and effective treatment for nasolacrimal obstruction.
• The laser technique offers advantages in terms of reduced invasiveness, shorter procedure time, and outpatient suitability.
• ELDC provides comparable results to conventional DCR with improved patient experience.