Efficacy of powered endoscopic dacryocystorhinostomy in treatment of nasolacrimal duct obstruction

Background and Objectives: To evaluate the success rate of the therapeutic effectiveness and safety of endoscopic dacryocystorhinostomy to treat obstruction of the lacrimal pathway. Methods: The study involved prospective randomized case series. Operative and postoperative data were prospectively collected on 114 patients (120 eyes) who presented to Rizgary Teaching Hospital (Erbil city – Iraq) with epiphora and obstruction of the nasolacrimal system, from February 2013 until October 2017. All patients consecutively underwent endoscopic dacryocystorhinostomy. The follow-up evaluation included system evaluation and endoscopic assessment of the newly created ostium; the follow-up was done at 1 week, 1 month, and 3 months postoperatively, and results were compared between the different groups. Results: A total of 120 cases of endoscopic dacryocystorhinostomy were performed on 114 patients. Procedure success rate was around 95.8%using powered drill and endoscopic system with minimum complication. Age group of 25-44 years (45.8%) is the higher percentage and the female gender accounts for 83.3%. No complications were recorded in78.3% of the patients, while 10% had developed granulation tissue at fistula site. Only 5%of the cases suffered from synechia and 5.7%were miscellaneous complications. No statistical significant differences were found between the surgery and age, gender, or side of operation. Conclusion: Powered endoscopic dacryocystorhinostomy is the most suitable treatment for patients at the level of the sac or in the nasolacrimal duct obstruction.