Laser-assisted dacryocystorhinostomy in nasolacrimal duct obstruction: 5-year follow-up.

Aim: To evaluate the long-term sucess rate of laser-assisted dacryocystorhinostomy (L-DCR) in patients with nasolacrimal duct obstruction (NDO).

Methods: Forty-one eyes of forty patients aged between 21-85y (mean 56.7y) who underwent L-DCR for the treatment of NDO were included in this retrospective, non-randomized study. The follow-up time was 72mo. Functional sucess was defined as the disappearance of epiphora under normal conditions and the presence of a patent ostium on lacrimal irrigation. Anatomical success was defined as a patent lacrimal passage on syringing besides continuing epiphora. Surgical failure was defined as persistent epiphora and closed ostium.

Results: Twenty-seven of 40 patients (67.5%) were female and 13 of 40 patients (32.5%) were male. The NDO was right-sided in 17 (42.5%) patients and left-sided in 22 (55%) patients whereas 1 (2.5%) patient had undergone bilateral surgery. In 11 (27.5%) patients there were additional nasal abnormalities requiring simultaneous surgical approach. The average time for L-DCR was 26.50±4.9min (16-39min) and the average total amount of laser energy used was 287±27.9 J (239-367 J). At the 5y follow-up, anatomical sucess rate was 75.0% (30 patients) and functional success rate was 65.0% (26 patients), whereas surgical failure was seen in 25% (10 patients). Revision of surgery was performed in 10 cases (25.0%); failure of revision surgery was seen in 2 cases (5.0%).

Conclusion: Transcanalicular L-DCR is a reliable and fast procedure in the treatment of NDO. It can be alternative to external DCR which is accepted as the gold standard currently. The functional and anatomical success rate is higher in the first months and years, but still satisfactory at fifth year.