Transcanalicular Diode Laser-Assisted Dacryocystorhinostomy - Success Rates and Related Factors During 3 Years of Follow-Up.

Purpose: To evaluate the success rates of transcanalicular diode laser-assisted dacryocystorhinostomy (TCL-DCR) during 3 years of follow-up and to find clinical factors that influence surgical outcomes.

Methods

Major outcomes were the anatomical success defined as a patent neo-ostium tested by irrigation and the functional success defined as a patent osteotomy with the absence of epiphora, accessed at 6-month, 1, 2, and 3-year follow-up visits. To determine which factors influence success rates, patients were divided according to gender, age, previous lacrimal surgeries, nasosinusal anatomy, energy employed, treatment with topical prostaglandin analogs, and timing of extubation.

Results

A total of 134 eyes were included. 55.2% of patients underwent peribulbar block. The surgical mean duration was 30.6 min. We obtained anatomical and functional success rates of 80.0% and 70.8% at 6 months; 69.3% and 61.4% at 1 year; 64.2% and 58.0% at 2 years; 56.4% and 46.2% at 3 years, respectively. Functional success was significantly higher in younger patients (p = .008). Bicanalicular intubation for 2 months improved anatomical and functional success rates (p = .028 and p = .001, respectively). No other factors showed a significant impact. 85.8% of patients didn´t experience any complications. Palpebral swelling was the most frequent complication.

Conclusion

TCL-DCR is a minimally invasive, repeatable, and safe alternative to treat nasolacrimal duct obstructions. We found success rates comparable to literature and stated that younger patients and those intubated for 2 months show better results.