Outcome comparison between transcanalicular and external dacryocystorhinostomy

Abstract

Aim: To compare the outcomes achieved with external dacryocystorhinostomy (EX-DCR) and transcanalicular dacryocystorhinostomy (TC-DCR) using a multidiode laser in patients with bilateral nasolacrimal duct obstruction (NLDO). Methods: This prospective study was conducted on 38 eyes of 19 patients with bilateral NLDO. Simultaneous bilateral surgery was performed on all patients. TC-DCR (Group 1) with a diode laser was used in the right eye, and EX-DCR (Group 2) was used in the left eye. All patients were placed under general anesthesia. Routine follow ups were scheduled at 1wk; 1, 3, 6 and 12mo postoperative intervals. Objective (lacrimal system irrigation) and subjective [tearing, irritation, pain, discharge and visual analogue scale (VAS) score] outcomes were evaluated. Results: The overall objective success rate at 12mo was 73.7% (14/19) in Group 1 and 89.5 % (17/19) in Group 2. This difference was statistically significant. There were no significant between group differences in the subjective results, such as tearing, pain and irritation. Only the discharge scores were found to be significantly higher in Group 1 compared to Group 2 at the 1y follow up. The average VAS score was 6.8 in Group 1 and 8.7 in Group 2, with no statistically significant differences. Conclusion: Although TC-DCR allows surgeons to perform a minimally invasive and safe procedure, EX-DCR offers better objective and subjective outcomes than TC-DCR.