AIM: To compare the outcomes achieved with external dacryocystorhinostomy(EX-DCR) and transcanalicular dacryocystorhinostomy(TC-DCR) using a multidiode laser in patients with bilateral nasolacrimal duct obstruction(NL...AIM: To compare the outcomes achieved with external dacryocystorhinostomy(EX-DCR) and transcanalicular dacryocystorhinostomy(TC-DCR) using a multidiode laser in patients with bilateral nasolacrimal duct obstruction(NLDO).METHODS: This prospective study was conducted on38 eyes of 19 patients with bilateral NLDO. Simultaneous bilateral surgery was performed on all patients. TC-DCR(Group 1) with a diode laser was used in the right eye,and EX-DCR(Group 2) was used in the left eye. All patients were placed under general anesthesia. Routine follow-ups were scheduled at 1wk; 1, 3, 6 and 12 mo postoperative intervals. Objective(lacrimal system irrigation) and subjective [tearing, irritation, pain,discharge and visual analogue scale(VAS) score]outcomes were evaluated.RESULTS: The overall objective success rate at 12 mo was 73.7%(14/19) in Group 1 and 89.5 %(17/19) in Group2. This difference was statistically significant. There were no significant between-group differences in the subjective results, such as tearing, pain and irritation.Only the discharge scores were found to be significantly higher in Group 1 compared to Group 2 at the 1y followup. The average VAS score was 6.8 in Group 1 and 8.7 in Group 2, with no statistically significant differences.CONCLUSION: Although TC-DCR allows surgeons to perform a minimally invasive and safe procedure, EX-DCR offers better objective and subjective outcomes than TC-DCR.展开更多
Purpose: To compare perioperative and postoperative outcomes of the first and following 50 cases of transcanalicular laser dacryocystorhinostomy performed by a surgeon team. Methods: Results of 124 eyes of 115 patient...Purpose: To compare perioperative and postoperative outcomes of the first and following 50 cases of transcanalicular laser dacryocystorhinostomy performed by a surgeon team. Methods: Results of 124 eyes of 115 patients who had a diagnosis of distal obstruction of the lacrimal drainage system and underwent transcanalicular laser dacryocystorhinostomy procedures were retrospectively detected. Initial 50 eyes were considered as group 1;74 following eyes were accepted as group 2. Groups were compared regarding age, gender, total surgical time, time for creation of osteotomy, pain score, bleeding score, anatomic and functional success rates. Results: The average total surgical time was 43.2 ± 6.0 minutes (range: 31 to 65 minutes) in group 1, and 30.0 ± 6.4 minutes (range: 21 to 57 minutes) in group 2 (p < 0.001). Laser osteotomy creation required 25.0 ± 4.2 minutes (range: 14 to 34 minutes) in group 1, and 14.6 ± 3.6 months (range: 9 to 28 minutes) (p < 0.001). Intraoperative pain and bleeding scores were significantly better in group 2 (p < 0.001 and p < 0.001 respectively). Success rate was 54.0% in group 1, and 85.1% in group 2 (p < 0.001). Conclusion: The results of current study clearly showed that increased experience of a surgeon results with improvement of better surgical outcomes. Initial studies about a novel technique should make clear if the study cases are the beginning cases of the authors.展开更多
文摘AIM: To compare the outcomes achieved with external dacryocystorhinostomy(EX-DCR) and transcanalicular dacryocystorhinostomy(TC-DCR) using a multidiode laser in patients with bilateral nasolacrimal duct obstruction(NLDO).METHODS: This prospective study was conducted on38 eyes of 19 patients with bilateral NLDO. Simultaneous bilateral surgery was performed on all patients. TC-DCR(Group 1) with a diode laser was used in the right eye,and EX-DCR(Group 2) was used in the left eye. All patients were placed under general anesthesia. Routine follow-ups were scheduled at 1wk; 1, 3, 6 and 12 mo postoperative intervals. Objective(lacrimal system irrigation) and subjective [tearing, irritation, pain,discharge and visual analogue scale(VAS) score]outcomes were evaluated.RESULTS: The overall objective success rate at 12 mo was 73.7%(14/19) in Group 1 and 89.5 %(17/19) in Group2. This difference was statistically significant. There were no significant between-group differences in the subjective results, such as tearing, pain and irritation.Only the discharge scores were found to be significantly higher in Group 1 compared to Group 2 at the 1y followup. The average VAS score was 6.8 in Group 1 and 8.7 in Group 2, with no statistically significant differences.CONCLUSION: Although TC-DCR allows surgeons to perform a minimally invasive and safe procedure, EX-DCR offers better objective and subjective outcomes than TC-DCR.
文摘Purpose: To compare perioperative and postoperative outcomes of the first and following 50 cases of transcanalicular laser dacryocystorhinostomy performed by a surgeon team. Methods: Results of 124 eyes of 115 patients who had a diagnosis of distal obstruction of the lacrimal drainage system and underwent transcanalicular laser dacryocystorhinostomy procedures were retrospectively detected. Initial 50 eyes were considered as group 1;74 following eyes were accepted as group 2. Groups were compared regarding age, gender, total surgical time, time for creation of osteotomy, pain score, bleeding score, anatomic and functional success rates. Results: The average total surgical time was 43.2 ± 6.0 minutes (range: 31 to 65 minutes) in group 1, and 30.0 ± 6.4 minutes (range: 21 to 57 minutes) in group 2 (p < 0.001). Laser osteotomy creation required 25.0 ± 4.2 minutes (range: 14 to 34 minutes) in group 1, and 14.6 ± 3.6 months (range: 9 to 28 minutes) (p < 0.001). Intraoperative pain and bleeding scores were significantly better in group 2 (p < 0.001 and p < 0.001 respectively). Success rate was 54.0% in group 1, and 85.1% in group 2 (p < 0.001). Conclusion: The results of current study clearly showed that increased experience of a surgeon results with improvement of better surgical outcomes. Initial studies about a novel technique should make clear if the study cases are the beginning cases of the authors.
