RESULTS OF ENDOSCOPIC KTP LASER-ASSISTED DACRYOCYSTORHINOSTOMY

Nineteen consecutive cases of primary endoscopic potassium titanyl pho sphate (KTP) laser-assisted dacryocystorhinostomy (DCR) were retrospec tively studied. Follow-up ranged from 10 to 16 months. Patients ranged in age from 18 to 93 years (average 65.6 years). Preoperative epiphor a was present in all patients, and associated with mucopyocele in nine patients. Bicanalicular-nasal silicone tubes were placed during surge ry in all cases. Timing of tube removal in the office ranged from 5 to 15 weeks (average 8.9 weeks). Prolonged patency through the follow-up period was achieved in 13 of 19 cases (68.4%). The six cases (31.6%) of postoperative failure included three cases with preoperative mucopy ocele and three cases without. Failures manifested with recurrent epip hora (three cases) or recurrent dacryocystitis (three cases); the onse t of symptom recurrence varied from 7 to 27 weeks postoperatively (ave rage 18.3 weeks). Although success rates will vary between surgeons an d study populations, patients should be advised that the success rate of KTP laser-assisted DCR may be lower than that of standard DCR. Gene rally, indications for choosing laser-assisted DCR include the avoidan ce of a cutaneous incision and reduced potential for mucosal bleeding. The technique may be considered for use in selected cases of nasolacr imal obstruction. The importance of technical variations remains to be elucidated including rhinostomy size and timing of silicone tube remo val. Further studies are needed to help define the role of endoscopy t echniques and lasers in DCR surgery.