A comparison of mechanical transnasal endoscopic dacryocystorhinostomy, transcanalicular diode laser dacryocystorhinostomy and transcanalicular multidiode laser dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction: A prospective clinical trial

The purpose of this study is to compare three recent dacryocysorhinostomy techniques in epiphora treatment prospectively. Among those who applied to Gazi University Medical School Oculoplastics and Orbital Surgery division with tearing complaint, 45 patients presenting persistent epiphora due to acquired nasolacrimal duct obstruction were included in the study. The patients were divided into 3 groups of 15 persons. Mechanical Endoscopic DCR, Transcanalicular Dacryocysorhinostomy (TC-DCR) with Diode Laser and TC-DCR with Multidiode Laser techniques applied in the groups respectively. Follow-up is conducted in the first day, first month and then in three-month periods prospectively and results were compared using statistical methods. 7 patients were male, 38 were female and mean age was 40,53±3,96 years. Mean follow-up times were; 26,13±1,03, 35,80±5,54 and 7,0±2,9 months respectively. The main outcomes were the relief of epiphora and the patency on lacrimal irrigation. Complete resolution is achieved in first group whereas failures recorded in the third due to 1 patient suffering canalicular stenosis and in the second due to 8 patients with fibrosis at rhinostomy site. Six-month success rates were 100% in the first, 73,3% in the second and 90,9% in the third group. Success rate in Diode Laser DCR group regressed to 46,7% following 9th month and remained so. In 26,13±1,03 month-period no failure detected in endoscopic group. Multidiode Laser group lacks long-term results. Thus, Mechanic Endoscopic DCR is a strong substitute for External DCR. Transcanalicular Diode Laser DCR could not perform well in the long-term. Transcanalicular Multidiode DCR looks promising with early results yet no long-term results exist.