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Ophthalmology. 1998 Jun;105(6):1106-13.

Prospective randomized comparison of external dacryocystorhinostomy and endonasal laser dacryocystorhinostomy.

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1
Department of Ophthalmology, University of Turku, Finland.

Abstract

OBJECTIVE AND DESIGN:

The introduction of endonasal laser dacryocystorhinostomy (ENL-DCR) in the early 1990s showed great promise of changing dacryocystorhinostomy into an elegant, minimally invasive procedure from the traditional external dacryocystorhinostomy (EXT-DCR). This prospective, randomized study compares these two operations, their success rates, surgical durations, and postoperative symptoms.

PARTICIPANTS:

A total of 64 cases in 61 patients with primary acquired nasolacrimal sac or duct obstruction were divided into 2 subgroups by symptoms (simple epiphora and chronic dacryocystitis). These patients were randomized within both subgroups into 2 operation groups with 32 cases in each group.

INTERVENTION:

Altogether, 32 EXT-DCRs and 32 ENL-DCRs were performed. The silicone tube was removed at 6 months after surgery. The final follow-up visit was at 1 year after surgery. The patency of the lacrimal passage was investigated by irrigation, and patients were questioned about their symptoms.

MAIN OUTCOME MEASURES:

The patency of the lacrimal passage to irrigation and the duration of surgery were measured.

RESULTS:

The success rate at 1 year after surgery was 91% for EXT-DCR and 63% for ENL-DCR after primary surgery. The difference was statistically significant (P = 0.016). The surgical duration for ENL-DCR was three times shorter than for EXT-DCR, the average duration being 23 minutes and 78 minutes, respectively (P < 0.0001).

CONCLUSIONS:

The EXT-DCR, when compared with ENL-DCR, seems to provide superior operation results in primary acquired nasolacrimal duct obstruction.

PMID:
9627664
DOI:
10.1016/S0161-6420(98)96015-8
[Indexed for MEDLINE]

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