Four-year experience with intranasal transilluminating dacryocystorhinostomy using ultrasound.

Background: The aim of this study was to investigate the results obtained by intranasal dacryocystorhinostomy.

Methods: This was a prospective, non-randomised, non-comparative case series study of 150 patients with epiphora due to nasolacrimal duct obstruction. The same team of ophthalmic and otorhinologic surgeons performed the transilluminating intranasal dacryocystorhinostomy using ultrasound. The main outcome measures were subjective improvement of epiphora, dye testing, lacrimal probing, lacrimal irrigation, and endoscopic nasal examination.

Results: Symptomatic relief and patency of the lacrimal apparatus was achieved in 92% (138) of the patients at the 3-month follow-up and 89% (134) at the 6-month follow-up. At 1 year, only 2 patients of the 134 initial successes showed obstruction of the nasolacrimal duct. All 16 successful patients that we have followed for 4 years have sustained their improvement.

Interpretation: Transilluminating intranasal dacryocystorhinostomy is a quick and safe option for the treatment of nasolacrimal duct obstruction. The main advantages over external dacryocystorhinostomy are avoidance of skin incision, reduced haemorrhage, shorter duration of the operation, and quicker recovery of the patient.