Mechanical transnasal endoscopic dacryocystorhinostomy versus transcanalicular multidiode laser dacryocystorhinostomy: long-term results of a prospective study


The purpose of this study is to compare two dacryocystorhinostomy (DCR) techniques in epiphora treatment. This study is a prospective randomized trial. Twenty-nine patients presenting persistent epiphora due to primary acquired nasolacrimal duct obstruction (PANDO) were included in the study. Two groups each consisting of 15 eyes were formed. Mechanical transnasal endoscopic DCR (MTE-DCR) was applied to the first group, while transcanalicular dacryocystorhinostomy with multidiode laser (TCML-DCR) techniques is employed in the second group. Follow-up is conducted in the first day, first week, and first month of the dacryocystorhinostomy which is followed by 4-month follow-up period, and results were compared using statistical methods. The main outcome measures were the elimination of epiphora and unrestricted flow of irrigated saline to the nose. Seven patients were male, 22 were female, and the mean age was 39.3 ± 12.5 years. Mean follow-up times were 111.3 ± 10.5 months and 93 ± 2.9 months in group 1 and group 2, respectively. Complete resolution is achieved in group 1, whereas failures stemming from canalicular stenosis and fibrosis at osteotomy site are recorded in two cases in group 2. Occlusion occurred in the fifth month in both cases. Thus, long-term success rates were 100% in the first and 86.6% in the second group (P = 0.483). MTE-DCR is a strong substitute for external DCR. Although TCML-DCR shows promising results, it is far away from becoming the gold standard technique in epiphora treatment.

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Data availability

The datasets generated and/or analyzed during the present study are not publicly available (obtained from Gazi University Hospital, Ankara repository) but are available from the corresponding author upon reasonable request.


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Meeting presentation and other information

This study is a doctoral dissertation and was presented in 46th Turkish Ophthalmology Society National Congress (17–21 October 2012, Antalya, Turkey) as an oral presentation.

Author information




HTA, OK: study design, critical revision; HTA: data acquisition, interpretation, article writing;

OK: performing surgeries, supervision. All the authors have read and approved the final manuscript.

Corresponding author

Correspondence to Hanife Tuba Akcam.

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The authors declare that they have no competing interests.

Ethical approval

This prospectively randomized controlled study received approval from the Gazi University Ethical Committee (IRB#2008–366), and the tenets of the Declaration of Helsinki (2008) were followed.

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Written informed consent was obtained from each patient before his/her participation.

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Akcam, H.T., Konuk, O. Mechanical transnasal endoscopic dacryocystorhinostomy versus transcanalicular multidiode laser dacryocystorhinostomy: long-term results of a prospective study. Lasers Med Sci 36, 349–356 (2021).

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  • Dacryocystorhinostomy
  • Laser DCR
  • Multidiode laser
  • Nasolacrimal duct
  • NLDO