1. Miroslav Knežević, Medicinski fakultet Univerziteta u Beogradu, Klinika za očne bolesti KCS, Serbia
Miroslav Knežević1,2 Gordana Vlajković1,2, Dejan M Rašić1,2 1 Faculty of Medicine, University of Belgrade, Serbia 2 Clinic of Eye Diseases Clinical Centre of Serbia Aim To present, compare and evaluate the outcomes and effectiveness of endoscopic endonasal instrumental dacryocystorhinostomy (EN-DCR), trans-canalicular laser-assisted dacryocystorhinostomy (TCL-DCR) and traditional external dacryocystorhinostomy (EX-DCR) in patients operated for primary lacrimonasal duct obstruction. Material and methods This is retrospective, nonrandomized, comparative interventional case series. A total of 189 consecutive patients with primary lacrimonasal duct obstruction, in a two-year period (2010-2011), at the Clinic of Eye Diseases Clinical Centre of Serbia, were managed by means of surgery – 48 by EN-DCR, 16 by TCL-DCR and 125 by EX-DCR. EN-DCR and TCL-DCR were done under general anesthesia, EX-DCR under local anesthesia. All procedures were performed by one surgeon (MK) and followed up to one year. Results Full success was achieved in 91.64% of EN-DCR patients [failure rate was 8.33% (4 out of 48 patients)], 87.5% of EN-DCR [failure rate was 12.5% (2 out of 16 patients), and 92% of EX-DCR [failure rate was 8% (10 out of 125 patients)]. There was no statistical significance between these outcomes. Conclusion Equivalent and high surgical success rate was achieved by EN-DCR and EX-DCR. Non-equivalent but not statisticaly significant lower success rate of TCL-DCR certainly is influenced by time/small-number-of-patients-operated related learning curve. The main advantages of EN-DCR and EN-DCR are better postoperative cosmetic appearance (there are no skin scars) but the main disadvantage is expensive equipment.
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