Outcome of Transcanalicular Endonasal Diode Laser-Assisted Dacryocystorhinostomy in Patients of Chronic Dacryocystitis

Objective: This study is conducted to evaluate the efficacy of transcanalicular diode laser dacryocystorhinostomy in chronic dacryocystitis patients.

Methods: The study group comprised 24 patients. The cases were operated on by one team to make the uniform analysis and its result. There were 6 males and 18 females in this study, and the male-to-female ratio was 1:3. the mean age of the patients was 34.27 years (range from 14 years to 68 years). Patients with epiphora, mucocele, lacrimal sac fistula, and recurrent dacryocystitis were included in the present study. Patients below 10 years of age and those having canalicular block, granulomatous diseases, or malignancy were excluded. All the patients had undergone endoscopic transcanalicular diode laser dacryocystorhinostomy(DCR) surgery under general anesthesia. The free flow of saline through newly created stoma during sac syringing was considered as a successful outcome. Stents were used in most of the cases. The average follow-up period was 6 months.

Results: The success rate was 83.34%. One patient developed failure due to allergic reaction to stent material. One patient had accidental removal of the stent at the second month. Two patients had lower punctal injury, and one patient developed cheese wiring due to silicon stent. One patient developed nasal synechiae after surgery, but these were asymptomatic and removed via an office procedure.

Conclusion: The transcanalicular DCR with diode laser is safe with comparable success rate without any complications. Along with advantages of the endonasal approach in terms of no facial scar and maintained lacrimal pump mechanism, in the transcanalicular approach, laser energy is directed toward the lacrimal nasal sac, not toward the eye or orbit.