Comparison of Nonlaser Endoscopic Endonasal Revision Surgery and Diode Laser Transcanalicular Revision Surgery for Failed Dacryocystorhinostomy

Background: Numerous surgical techniques for failed dacryocystorhinostomy (DCR) have been described. The aim of this study was to compare nonlaser endoscopic endonasal DCR revision surgery and diode laser transcanalicular DCR revision surgery. This study described the success rate, merits, and demerits of each surgery, and compared them. Patients and Methods: As retrospective comparative study, 76 patients, who underwent revision DCR between January 2005 and September 2010, were included. The patients were divided into 2 groups. Group 1 consisted of 34 patients (average 59.2 yr), who were treated with nonlaser endoscopic endonasal revision DCR. Group 2 consisted of 42 patients (average 58.7 yr), who were treated with diode laser transcanalicular revision DCR. The visual analog scale (VAS) was used for clinical pain assessment. The mean follow-up period was 12.8 months for group 1 and 12.2 months for group 2. Results: Success of revision DCR was defined as resolution of epiphora and patency of nasolacrimal drainage system, confirmed by irrigation and endoscopic examination. Moreover, 88.2% of patients (30 of 34 cases) were successful in group 1 and 90.5% (38 of 42 cases) in group 2. This difference was not statistically significant (P = 0.519). The operating time in group 2 (25.4 min) was significantly shorter than that of group 1 (43.8 min) (P< 0.001). The average VAS score of group 1 was 3.9 +/- 1.4, compared with 1.9 +/- 1.2 of group 2 (P< 0.001). Conclusions: There is no significant difference in success rates of the 2 groups. However, diode laser transcanalicular revision DCR is recommended, as operating time was shorter and showed lower VAS score.