Comparison of Endoscopic Laser Assisted Dacryocystorhinostomy with Conventional External Dacryocystorhinostomy Surgery

Objective: To compare the effectiveness and outcomes of endoscopic laser assisted dacryocystorhinostomy (DCR) with conventional external dacryocystorhinostomy (DCR) for symptomatic nasolacrimal duct occlusion (NLDO). Study Design: Quasi-experimental study. Place and Duration of Study: Ophthalmology department at Combined Military Hospital, Multan from March 2023 to Feb 2024. Methodology: 40 participants (n=40) were included in this study through non-probability convenience sampling technique. Twenty participants (n=20) were treated by conventional external DCR surgery (Group A), while the other twenty (n=20) underwent laser endoscopic DCR surgery (Group B). Primary outcomes included overall success rate, defined as absence of symptoms when accompanied by functioning tear drainage system; and secondary outcomes measures which were complication rates, cosmesis and patient satisfaction. Data was collected through preoperative examination as well as postoperative follow-up for up to 3 months. Results: Among the total 40 patients, 52.5% were male & 47.5% were female. Average age in group A and group B was 47.25± 8.1 years and 46.5±6.8 years respectively. Both Group A and Group B exhibited significant success rates (p=0.543), with lower complication rates in Group B (p=0.217). Additionally, higher patient satisfaction scores were observed in Group B (p=0.659), with comparable cosmesis outcomes between the two groups (p=0.423). Conclusion: Both endoscopic laser assisted DCR and conventional external DCR were relatively equal in terms of relieving NLDO. However, laser endoscopic DCR offered additional merits which included time saving, low invasiveness, no need for general anesthesia, good cosmetic effect, higher patient satisfaction, lower complication rates and relatively bloodless surgery.