Long-Term Results of External Dacryocystorhinostomy

Abstract

* BACKGROUND AND OBJECTIVE: To evaluate the long-term success following external dacryocystorhinostomy, which is used as a standard in comparing endoscopic or laser techniques. * PATIENTS AND METHODS: A chart review of 128 patients (150 procedures) undergoing external dacryocystorhinostomy within a 14-year period was undertaken. Patient demographics, symptoms, examination findings, surgical and anesthesia information, postoperative course, and complications were recorded. Lack of tearing or evidence of dacryocystitis at the final postoperative visit was considered a successful result. * RESULTS: External dacryocystorhinostomy was found to be highly successful, with an overall 93% success rate at an average follow-up of 2.7 years. Kaplan-Meier analysis of the data, applied for the first time in this study, predicts a success rate of 90% beyond 4 years. Most important, this demonstrated that most surgical failures were identified in the first 2 years. Postoperative complications were rare and the surgical scar was not a source of patient concern in most cases. * CONCLUSIONS: This study confirms that external dacryocystorhinostomy is a highly successful longterm solution to nasolacrimal duct obstruction with low morbidity. [Ophthalmic Surg Lasers Imaging 2005;36:446450.]

Transcanalicular Diode Laser Assisted Dacryocystorhinostomy in Primary Acquired Nasolacrimal Duct Obstruction

“…The search for an ideal DCR technique that can be carried out quickly and easily with a high success rate, and without leaving a scar, still continues. [4][5][6][7][8][9][10] With the development of high-resolution fiber-optic endoscopes and fine endonasal surgical tools in the late 1980s, the quest for an ideal DCR technique intensified the interest in the endonasal lacrimal surgery, which was first performed by Caldwell in 1893. [11][12][13][14][15][16][17] In endoscopic lacrimal surgery, laser energy can be used to create rhinostomy.…”

Subciliary Incision for External Dacryocystorhinostomy

“…1,2 The success rates of Ex-DCR have been reported to be over 90% in most published series. 1,2 The success rates of Ex-DCR have been reported to be over 90% in most published series.…”

External Versus Endoscopic Endonasal Dacryocystorhinostomy

“…Many previous reports evaluating external DCRs have shown high success rates. [39][40][41] There has been only 1 prospective, randomized study comparing external and nonlaser endoscopic DCR. 19 In this study, the 1-year success rate was 91% for external DCR and 75% for endoscopic DCR (P = 0.18).…”

“…24,26,29,[39][40][41] The reported success rate of endoscopic DCR ranges from 60% to 99%. 26,[30][31][32][33][34] Numerous reports have shown that external DCR has a higher success rate than endoscopic DCR, and therefore the general consensus has been that endoscopic DCR has lower success rates.…”