Anatomical and functional outcomes of transcanalicular diode laser assisted dacryocystorhinostomy as a primary procedure

The goal of this study was to assess the efficacy of transcanalicular diode laser assisted dacryocystorhinostomy (TDL-DCR) for the treatment of primary acquired nasolacrimal duct obstruction. This was a single center retrospective study. We included all patients who underwent TDL-DCR between July 2015 and October 2017 for chronic epiphora or chronic dacryocystitis. All procedures were performed under local anesthesia with sedation. The anatomical and functional success rates were studied as a function of each operative indication. Thirty-seven patients were included (18 had chronic epiphora and 19 had chronic dacryocystitis). All but one patient had bicanalicular silicone stent intubation. Irrigation of the lacrimal system demonstrated postoperative patency in 78% of patients operated for chronic epiphora and 76% of those with chronic dacryocystitis. The functional success of the surgery (as defined by the Munk score) was higher if the operative indication was chronic dacryocystitis (62%) (whereas it was only 41% for the indication of chronic epiphora). TDL-DCR has a lower anatomical and functional success rate than those reported in the literature for external or endonasal dacryocystorhinostomy. However, it retains a place in the treatment of primary acquired nasolacrimal duct obstruction (in particular when it is complicated by chronic dacryocystitis), especially if there is an absolute or relative contraindication to the two other dacryocystorhinostomy techniques. Cette étude a pour objectif d’évaluer l’efficacité de la dacryocystorhinostomie transcanaliculaire au laser diode pour le traitement de l’obstruction primaire du conduit lacrymo-nasal. Étude rétrospective monocentrique. Nous avons inclus les patients opérés de dacryocystorhinostomie transcanaliculaire au laser diode entre juillet 2015 et octobre 2017 pour un épiphora chronique ou une dacryocystite chronique. Toutes les interventions ont été réalisées sous anesthésie locale et sédation. Les taux de succès anatomique et fonctionnel ont été étudiés en fonction de chaque indication opératoire. Trente-sept patients ont été inclus (18 avaient un épiphora chronique et 19 une dacryocystite chronique). Tous les patients ont eu une intubation bicanaliculaire en silicone, sauf un. L’irrigation du système lacrymal était perméable en postopératoire chez 78 % des patients opérés pour un épiphora chronique et 76 % de ceux qui avaient une dacryocystite chronique. Le succès fonctionnel de la chirurgie (défini