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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Retrospective study of success rate and associated factors of two laser dacryocy...
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Vol. 98. Issue 8.
Pages 427-433 (August 2023)
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Vol. 98. Issue 8.
Pages 427-433 (August 2023)
Original article
Retrospective study of success rate and associated factors of two laser dacryocystorhinostomy techniques, in a third-level hospital
Estudio retrospectivo de tasa de éxito y factores asociados de dos técnicas de dacriocistorrinostomía láser, en un hospital de tercer nivel
A. Berrocal-Cuadrado, H. Sánchez-Tocino, A. Galindo-Ferreiro
Corresponding author
ali_galindo@yahoo.es

Corresponding author.
Servicio Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain
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Tables (5)
Table 1. Summary of published papers on mitomycin laser dacryocystorhinostomy from 2000 to 2022.
Table 2. Summary of published papers on laser dacryocystorhinostomy with endoscopic extension from 2000 to 2022.
Table 3. Demographic characteristics of tear duct patients undergoing laser dacryocystorhinostomy with mitomycin (DCRLend-amp + MMTC) and laser dacryocystorhinostomy associated with endosteal ostium enlargement with mitomycin (DCRLend-amp + MMTC) between 2000 and 2021.
Table 4. Functional and anatomical success rates of laser dacryocystorhinostomy with MMTC (DCRLend-amp + MMTC) and laser dacryocystorhinostomy associated with endoscopic ostium enlargement with MMTC (DCRLend-amp + MMTC) between 2000 and 2021.
Table 5. Intraoperative, postoperative findings, complication rate and anatomical patency at one year for dacryocystorhinostomy laser (DCRL) and dacryocystorhinostomy laser associated with endoscopic ostium enlargement (DCRLend-amp).
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Abstract
Background and objective

To compare the success rate of two laser dacryocystorhinostomy (L-DCR) techniques.

Materials and methods

A retrospective study of patients who underwent surgery for acquired nasolacrimal duct obstruction (NLDO) between 2000 and 2021, carried out in a third level hospital, using L-DCR and modifications of this technique. Intraoperative findings, complications, and anatomical and functional success rate of the 2 techniques were analyzed. The follow-up time was 1 year.

Results

We included 92 lacrimal ducts with NLDO. 66 (71.7%) were women. 78 (84.8%) underwent unilateral surgery. The mean age was 62.77 ± 13.08 years.

61 (66.3%) underwent intraoperative laser dacryocystorhinostomy with MMTC (L-DCR + MMTC) and 31 (33.6%) L-DCR associated with endoscopic ostium enlargement (L-DCRend-amp).

The one-year anatomical/functional success rate of the L-DCRend-amp + MMTC was 71%/64,5%. L-DCR + MMTC obtained a lower success rate, 65.6/60,7% (P = .391).

There were no differences throughout the follow-up between the anatomical or functional success rates of the 2 techniques, nor between the different visits (P > ,05).

Intraoperative findings rate was 3.63% in L-DCR + MMTC, and 32.26% in L-DCRend-amp + MMTC.

Postoperative complication rate was 3.27% in L-DCR + MMTC, and 3.23% in L-DCRend-amp + MMTC.

Conclusions

The L-DCRend-amp + MMTC gets a higher success rate than the L-DCR + MMTC. We must consider the surgical time-cost of the L-DCRend-amp + MMTC, as well as the learning curve of endoscopy techniques, and the skill of the surgeon, without a clear benefit in the success rate.

Keywords:
Laser dacryocystorhinostomy
Endocanalicular dacryocystorhinostomy
Modified laser dacryocystorhinostomy
Acquired lacrimal obstruction
Resumen
Objetivo

Comparar la tasa de éxito de dos técnicas de dacriocistorrinostomía láser (DCRL).

Materiales y métodos

Se realizó un estudio retrospectivo de pacientes intervenidos por obstrucción adquirida de la vía lagrimal (OAVL) entre los años 2000 y 2021 en un hospital de tercer nivel, mediante DCRL con mitomicina intraoperatoria (DCRL + MMTC) y de DCRL asociada a ampliación de ostium con endoscopio y MMTC (DCRLend-amp + MMTC). Se analizaron hallazgos intraoperatorios, complicaciones y tasa éxito anatómico y funcional de las dos técnicas. El tiempo de seguimiento fue de un año.

Resultados

Incluimos 92 vías lagrimales con OAVL. 71,7% mujeres, 84,8% unilaterales y edad media de 62,77 ± 13,08 años.

En 61 vías lagrimales se realizó DCRL + MMTC (66,3%) y en 31 (33,6%) DCRLend-amp + MMTC. La tasa de éxito anatómica/funcional al año de la DCRLend-amp + MMTC fue del 71%/64,5%; la DCRL + MMTC obtuvo una menor tasa de éxito, 65,6%/60,7% (P = ,391). No existen diferencias, a lo largo del seguimiento, entre las tasas de éxito anatómicas ni funcionales de las dos técnicas, ni en las distintas visitas (P > ,05). La tasa de hallazgos intraoperatorios fue 1,63% en DCRL + MMTC y 32,26% en DCRLend-amp + MMTC.

La tasa de complicaciones postoperatorias fue 3,27% en DCRL + MMTC y 3,23% en DCRLend-amp + MMTC.

Conclusiones

La DCRLend-amp + MMTC obtiene una tasa de éxito ligeramente más alta que la DCRL + MMTC. Debemos tener en cuenta el tiempo-coste quirúrgico aumentado de la DCRLend-amp + MMTC, curva de aprendizaje, y destreza del cirujano, sin un beneficio claro en la tasa de éxito.

Palabras clave:
Dacriocistorrinostomía láser
Dacriocistorrinostomía endocanalicular
Dacriocistorrinostomía láser modificada
Obstrucción adquirida vía lagrimal

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