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Long-term outcomes of primary transcanalicular laser dacryocystorhinostomy

  • Oculoplastics and Orbit
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Abstract

Purpose

To assess the long-term outcomes of transcanalicular laser dacryocystorhinostomy in cases of primary acquired nasolacrimal duct obstruction (PANDO).

Methods

Retrospective interventional case series was performed on all patients diagnosed with PANDO and who underwent a primary transcanalicular laser dacryocystorhinostomy from Jan 2014 to June 2016. The procedure was performed using 980 nm diode laser. All the patients additionally underwent intraoperative adjunctive procedures: mitomycin C application and silicone intubation. Patients were followed for up to 3 years after surgery. Anatomical success was defined as patent ostium on irrigation, and functional success was defined as resolution of epiphora. The parameters studied include patient demographics, clinical presentation, type of anesthesia, duration of surgery, laser energy delivered, complications, and anatomical and functional success. The variables influencing the outcomes were assessed. Statistical analysis was performed using the package Statistica (version 10.0, Statsoft, Poland).

Results

A total number of 205 patients were assessed. Of these, 73.17% (150/205) were females. The mean age of patients was 62.92 years. The mean laser energy used was 1060.09 J, and the mean operating time was 22.33 min. Approximately, 95% and 68% of the patients completed 1 year and 3 years of follow-up, respectively. The anatomical and functional success rates dropped significantly beyond the 3 months and 6 months postoperative period and maintained the lower success rates beyond 1-year follow-up for up to 3 years. The anatomical and functional success at the end of 3-year follow-up was 56.12% and 33.81%, respectively. The functional success was not affected by gender (P = 0.132), age (P = 0.956), laser energy (P = 0.626), or duration of the surgery (P = 0.906). However, the intraoperative pain scale was influenced by the laser energy (P < 0.001) and the duration of the surgery (P < 0.001).

Conclusion

The anatomical and functional outcomes of primary transcanalicular laser dacryocystorhinostomy are suboptimal and not encouraging in the long term.

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Acknowledgements

The author wishes to acknowledge the help of Mr Marek Jastrzebski with the statistical analysis.

Funding

Hyderabad Eye Research Foundation

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Authors and Affiliations

  1. Department of Ophthalmology, Jozef Strus City Hospital, Poznan, Poland

    Rafal Nowak

  2. Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Road No 2, Banjara Hills, Hyderabad, Telangana, 500034, India

    Rafal Nowak & Mohammad Javed Ali

  3. Department of Ophthalmology, Military Institute of Medicine, Warsaw, Poland

    Marek Rekas & Izabela Nowak Gospodarowicz

Authors
  1. Rafal Nowak
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  2. Marek Rekas
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  4. Mohammad Javed Ali
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Contributions

Rafal Nowak: Concepts, manuscript drafting, and manuscript approval

Marek Rekas: Supervision, guidance, review of the manuscript, and final approval

Izabela Nowak Gospodarowicz: Review of the manuscript, guidance, and approval

Mohammad Javed Ali: Concepts, manuscript drafting and critical review, and manuscript approval

Corresponding authors

Correspondence to Rafal Nowak or Mohammad Javed Ali.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the (Jozef Strus City Hospital, Poznan) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Prof. Ali receives royalties from Springer for his treatise “Principles and Practice of Lacrimal Surgery” (2nd ed), “Atlas of Lacrimal Drainage Disorders,” and “Video Atlas of Lacrimal Surgery.” The other authors declare no competing interests.

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Nowak, R., Rekas, M., Gospodarowicz, I.N. et al. Long-term outcomes of primary transcanalicular laser dacryocystorhinostomy. Graefes Arch Clin Exp Ophthalmol 259, 2425–2430 (2021). https://doi.org/10.1007/s00417-021-05165-5

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  • DOI: https://doi.org/10.1007/s00417-021-05165-5

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