RESULTS OF ENDONASAL LASER-ASSISTED DACRYOCYSTORHINOSTOMY

Background: Endonasal laser-assisted dacryocystorhinostomy has been a subject of much interest since its introduction in 1990, offering the potential advantages of decreased postoperative morbidity and the lack of a cutaneous scar. In this study, the authors report the results of 46 endonasal laser-assisted dacryocystorhinostomy procedures performe d on 42 patients between February 1991 and July 1992. Methods: The med ical records of all patients undergoing endonasal laser-assisted dacry ocystorhinostomy procedures were reviewed retrospectively in detail. P atients undergoing laser-assisted external dacryocystorhinostomies or conjunctivo-dacryocystorhinostomies and those with follow-up periods l ess than 4 months were not included in the study. Results: A total of 46 endonasal laser-assisted dacryocystorhinostomy procedures were perf ormed. Of these, 32 were successful and 14 failed after a single attem pt, yielding a success rate of 70% (32/46). Of the 14 patients with fa iled procedures, 6 underwent a second endonasal laser-assisted dacryoc ystorhinostomy. Of these, five were successful. The success rate calcu lated on the basis of one or two attempts was 80% (37/46). Conclusions : The science and technology of endonasal laser-assisted dacryocystorh inostomy is undergoing a continuous process of evolution as a number o f modifications are introduced, including better patient selection, mo re complete tissue removal at the osteotomy site, and the adjunctive u se of mitomycin C. As this process continues, it is likely that the su ccess rates in this modality will improve, making it an increasingly a ttractive alternative to external dacryocystorhinostomy.