Efficacy of Diode Laser-Assisted Endoscopic Dacryocystorhinostomy (DCR)

Background: Dacryocystorhinostomy (DCR) is a standard procedure for treating nasolacrimal duct obstruction (NLDO), a condition that causes chronic tearing, dacryocystitis, and discomfort. Traditional external DCR has been effective but involves visible scarring, prolonged recovery, and potential bleeding. The advent of minimally invasive, endoscopic DCR offers aesthetic benefits and quicker recovery. The addition of diode laser technology to endoscopic DCR aims to enhance precision, minimize tissue trauma, and improve patient outcomes. Objective: This study evaluates the efficacy of diode laser-assisted endoscopic DCR (LA-DCR) by assessing surgical outcomes, complication rates, and recovery parameters. Methods: A prospective, non-randomized clinical trial was conducted at a tertiary care hospital in Dhaka, Bangladesh, from January 2023 to January 2024. The study included 49 patients diagnosed with acquired NLDO, who underwent diode laser-assisted endoscopic DCR. The 980 nm diode laser was employed for mucosal incision and osteotomy creation. Postoperative care included antibiotic and steroid eye drops, with follow-up at 7, 15 days, 1, 3, and 6 months. Success rates, complications, and recovery were assessed via endoscopic examination and lacrimal system irrigation. Results: The study population had a diverse age distribution, with most patients (41.0%) in the 40-60 years range. The majority of patients were female (71.0%). The overall success rate was 88.0%, with a 12.0% failure rate. Associated nasal surgeries, such as septoplasty (16.5%) and turbinoplasty (2.0%), were performed. Minimal complications were noted, including middle turbinate injury (4.0%) and minor issues like sump syndrome, synechiae, and granulomas (2.0% each). Conclusion: Diode laser-assisted endoscopic DCR is a highly effective and minimally invasive treatment for NLDO, with a high success rate, minimal complications, and a low need for additional nasal surgeries. These findings align with existi