నైరూప్య

Experiences of Endocanalicular Laser Dacryocystorinostomy with Multi - Diode Laser

Seyfettin Erdem*, Ayhan Kaydu, Selahattin Balsak, Umut Dag, Mehmet Emin Dursun, Birgul Dursun and Sevin Soker Cakmak

Purpose: Chronic dacryocystitis is a common disease in the population and usually affects middle-aged women. We aimed to evaluate the efficacy and clinical outcomes of dacryocystorhinostomy (DCR) operations by endoanalytic multi-diode laser.

Methods: Twenty-nine eyes of 28 patients diagnosed with chronic dacryocystitis with nasolacrimal duct obstruction were included retrospectively in this study. Silicone tube implantation was performed in all cases by endocanalcular laser dacryocystorhinostomy (EDCR) with multi-diode laser with the help of 30 ° nasal video endoscope. Demographic data, follow-up time, anesthesia method and success rates were recorded. The success was assessed as epiphora passage and absence of major laser-induced intranasal injury.

Results: Seven of the cases were male (24.14%) and 22 were female (75.86%). The mean age was 32.9 ± 20.77 years (8-82). The mean follow-up was 3 to 24 months (mean 15.67 ± 5.40 months). Endocanalicular laser DCR was successfully applied in 29 patients. 20 patients (68.9%) did not have epiphora complaints. The cause of failure in 9 patients was mucosal construction on the edge of the osteotomy. One of the unsuccessful case was dacryocystitis secondary to trauma and the other had primer nasolacrimal duct obstruction. External DSR was performed on 9 of the unsuccessful cases. In one case; the area of nasal osteotomy was covered with fibrotic tissue. The nasolacrimal duct was opened by exposing the fibrotic tissue using endonasal endoscopy. Eight of the cases were pediatric. In seven of them, the endocanalicular laser DCR did not develop any occlusion.

Discussion: Although the long-term success rate is not as high as external DCR, Endocanalicular laser DCR is an alternative surgical method that can be performed with low complication rates, which can be well tolerated by patients in treatment of chronic dacryocystitis.