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. 2022 Mar 23:2022:3996854.
doi: 10.1155/2022/3996854. eCollection 2022.

A Comparison of Transcanalicular, Endonasal, and External Dacryocystorhinostomy in Functional Epiphora: A Minimum Two-Year Follow-Up Study

Can Ozturker  1   2 , Bayasgalan Purevdorj  2   3 , Gamze Ozturk Karabulut  1 , Gamal Seif  2 , Korhan Fazil  1 , Yasser Anwar Khan  2 , Pelin Kaynak  1
Affiliations

A Comparison of Transcanalicular, Endonasal, and External Dacryocystorhinostomy in Functional Epiphora: A Minimum Two-Year Follow-Up Study

Can Ozturker et al. J Ophthalmol. .

Abstract

Purpose: To compare the outcomes of transcanalicular diode laser-assisted dacryocystorhinostomy (TCL-DCR), nonendoscopic endonasal dacryocystorhinostomy (NEN-DCR), and external dacryocystorhinostomy (EXT-DCR) as first-line treatments for functional epiphora.

Methods: This multicenter, retrospective, case-control study included 135 eyes of 135 patients with functional epiphora (86 females and 49 males). Functional epiphora was diagnosed based on a patent lacrimal system with a delay in the fluorescein dye disappearance test (FDDT) or dacryoscintigraphy (DSG) and no ocular surface or eyelid abnormalities. The patients were treated with TCL-DCR (2008-2011) or Ext-DCR (2005-2008, 2011-2017) at Beyoglu Eye Research Hospital (Istanbul, Turkey) and NEN-DCR at Carrot Eye Surgery Clinic affiliated with the McMaster University (Hamilton, ON, Canada) (2010-2016). Success was defined as the absence of epiphora and the normalization of an earlier delayed FDDT after surgery.

Results: The TCL-DCR, NEN-DCR, and EXT-DCR groups consisted of 38, 47, and 50 eyes with 25.9, 44.2, and 45.9 months of follow-up. The success rate for TCL-DCR was 65.8%, 70.2% for NEN-DCR, and 84.0% for EXT-DCR. During the follow-up period, 13.2% of TCL-DCR cases and 6.4% of NEN-DCR cases developed an anatomic obstruction of the lacrimal system.

Conclusion: The EXT-DCR group had a higher success rate in the management of functional epiphora than the NEN-DCR and TCL-DCR groups and was significantly safer in terms of an iatrogenic anatomic block of the lacrimal system.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Delay of lacrimal transit on the left eye after 5 minutes demonstrated with fluorescein dye disappearance test (FDDT) (a) and dacryoscintigraphy (b).
Figure 2
Figure 2
Intraoperative images from three different types of DCR surgeries: TCL-DCR (a), NEN-DCR (b), and EXT-DCR (c).
Figure 3
Figure 3
Three different surgical techniques' outcomes.
Figure 4
Figure 4
The laser beam causing charring of the nasal mucosa and lacrimal sac during TCL-DCR.
See this image and copyright information in PMC

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