Estudio retrospectivo de tasa de éxito y factores asociados de dos técnicas de dacriocistorrinostomía láser, en un hospital de tercer nivel

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.