Success Rate of Combined Transcanalicular Diode Laser and Endoscopic Dacryocystorhinostomy in Patients of Nasolacrimal Duct Obstruction
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-1.13929Keywords:
Dacryocystorhinostomy, Endoscopy, Nasolacrimal Duct ObstructionAbstract
Objective: To determine the success rate of combined Endoscopic Dacryocystorhinostomy (DCR) and Transcanalicular Diode Laser DCR in patients with nasolacrimal duct obstruction.
Study Design: Analytical cross-sectional study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from March 2024 to Mar 2025.
Methodology: Patients presenting with epiphora and a positive regurgitation-on-pressure test were enrolled through convenience sampling. Pre-sac patency was assessed using lacrimal syringing, which confirmed complete nasolacrimal duct obstruction. All patients underwent combined Transcanalicular Diode Laser DCR and Endoscopic DCR performed as a simultaneous procedure. Outcomes were evaluated at a 6-month postoperative follow-up, assessing overall, anatomical, and functional success.
Results: A total of 150 patients were included, with a mean age of 54.9±9.8 years (range: 28–76 years). The overall success rate was 92.0%, while anatomical and functional success rates were 96.0% and 91.3%, respectively (p=0.016). Functional pathology was the leading cause of failure, and lid laxity (22.7%) was significantly associated with functional failure (23.5% vs 4.3%, p<0.01).
Conclusion: Combined Transcanalicular Diode Laser–Endoscopic DCR yielded high overall, anatomical, and functional success rates. Functional failure remained more common in patients with associated lid laxity.
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References
1. Harris S, Sweeney A, Yen M, Burkat C. Secondary Acquired Nasolacrimal Duct Obstruction. EyeWiki [Internet]. [cited 12 Oct 2025]. Available from:
https://eyewiki.org/Secondary_Acquired_Nasolacrimal_Duct_Obstruction
2. Ullrich K, Malhotra R, Patel BC. Dacryocystorhinostomy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. [cited 12 Oct 2025]. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK557851/
3. Yakopson V, Flanagan J, Ahn D, Luo B. Dacryocystorhinostomy: history, evolution and future directions. Saudi J Ophthalmol 2011; 25(1): 37–49.
https://doi.org/10.1016/j.sjopt.2010.10.012
4. Locatello LG, DeZan ER, Tarantini A, Lanzetta P, Miani C. External dacryocystorhinostomy: a critical overview of current evidence. Eur J Ophthalmol 2024; 35(1): 12–22. https://doi.org/10.1177/11206721241249214
5. Awais M, Naqvi SAH, Akram A, Shahid M. Transcanalicular diode laser assisted dacryocystorhinostomy: a breakthrough in acquired nasolacrimal duct obstruction. Pak J Med Sci 2020; 36(4). https://doi.org/10.12669/pjms.36.4.1906
6. Mansour HO, Elzaher HR, Tharwat E. Comparing the success rate of external DCR with anterior flap versus flap excision. Med Hypothesis Discov Innov Ophthalmol 2023; 12(1): 1–8. https://doi.org/10.51329/mehdiophthal1464
7. Różycki R, Skrzypiec Ł, Ulaszewska K. Effectiveness and factors influencing success of transcanalicular laser-assisted endoscopic DCR. Diagnostics 2024; 14(17): 1944.
https://doi.org/0.3390/diagnostics14171944
8. Evereklioglu C, Sener H, Polat OA. Success rate of external, endonasal, and transcanalicular laser DCR: network meta-analysis. Graefes Arch Clin Exp Ophthalmol 2023; 261(12): 3369–3384. https://doi.org/10.1007/s00417-023-06089-y
9. Rajabi MT, Shahraki K, Nozare A. External versus endoscopic DCR for primary acquired NLDO. Middle East Afr J Ophthalmol 2022; 29(1): 1–6.
https://doi.org/10.4103/meajo.meajo_238_21
10. Torun MT, Demirel S, Buyuk M. The role of rhinostomy ostium size on functional success in DCR. J Ophthalmol 2022.
https://doi.org/10.1155/2022/8287942
11. Wormald PJ. Powered endoscopic dacryocystorhinostomy. Laryngoscope 2002; 112(1): 69–72.
https://doi.org/10.1097/00005537-200201000-00012
12. Sung YS, Kim EH, Kim N, Jang SY. Functional failure after endoscopic dacryocystorhinostomy: Analysis of causes and management. PLoS One 2019; 14(12): e0227073.
https://doi.org/10.1371/journal.pone.0227073
13. Shams PN, Olver JM. Management of functional epiphora due to punctal laxity: role of the lateral tarsal strip procedure. JAMA Ophthalmol 2014; 132(1): 109–113.
https://doi.org/10.1001/jamaophthalmol.2013.5011
14. Tsirbas A, Wormald PJ. Endonasal dacryocystorhinostomy with mucosal flaps. Am J Ophthalmol 2003; 135(1): 76–83.
https://doi.org/10.1016/s0002-9394(02)01813-4
15. Eloy P, Bertrand B, Martinez M, Hoebeke M, Watelet JB. Endonasal dacryocystorhinostomy: indications, technique and results. Acta Otorhinolaryngol Belg 1995; 49(3): 271–276.
16. Naik MN, Honavar SG, Rath S. Transcanalicular diode laser-assisted dacryocystorhinostomy: outcome in 118 patients. Ophthalmic Plast Reconstr Surg 2008; 24(4): 241–245.
https://doi.org/10.1097/IOP.0b013e31817c894e
17. Ali MJ, Psaltis AJ, Wormald PJ. Long-term outcomes in endoscopic dacryocystorhinostomy: Primary and revision surgeries. Clin Exp Ophthalmol 2014; 42(7): 665–671.
https://doi.org/10.1111/ceo.12332
18. Wang K, Chen R, Liu S. Development and validation of a nomogram for predicting the need for concomitant endoscopic septoplasty during endonasal endoscopic dacryocystorhinostomy for chronic dacryocystitis with moderate nasal septum deviation. Quant Imaging Med Surg 2024; 14(10): 3848–3860.
https://doi.org/10.21037/qims-24-726
19. Prinja S, Dhanoa S, Singh G. A comparative study of endoscopic endonasal dacryocystorhinostomy with and without stenting. Acta Medica Int 2023; 10(2): 96–101.
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Copyright (c) 2026 Ammarah Ashraf Awan, Syeda Alishba Zahra Naqvi, Aisha Rafique, Ubaid Ullah Yasin, Waqas Rahim Butt, Syed Abid Hassan Naqvi
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