Paediatric laser DCR

Abstract

ABSTRACT.Purpose: Endoscopic laser dacrocystorhinostomy is an alternative procedure to external approach DCR in children. We report our results with 5 patients (6 eyes) with congenital nasolacrimal duct obstruction. Methods: Six endonasal DCR's were carried out using the KTP laser in patients with congenital nasolacrimal duct obstruction resistant to probing and intubation. Results: The follow-up ranged from 3-8 months. All patients experienced a recurrence of their symptoms postoperatively. Conclusion: Endoscopic laser assisted DCR is not a successful procedure in children.

Modified laser DCR for paediatric nasolacrimal duct obstruction

“…1,4 Inferior turbinate infracture is not routinely practised as it carries a risk of haemorrhage and formation of adhesions and synechiae. 17 Most authors favour intubation 1,17 before attempting DCR, which can cause punctual and canalicular damage, impairing the prognosis of subsequent surgery. We tend to repeat probing twice before proceeding to a DCR.…”

“…11,12 Its role in paediatric cases is yet to be evaluated and to our knowledge there has been only one case-series to date with 0% success. 17 One of the major advantages of endonasal laser DCR is the reduced operating time. The average time taken for surgery was 23 min compared to 78 min in external DCR in a comparative study.…”

“…All patients in Doyle's group had granulation tissue on the first postoperative visit compared to one in our study. 17 Another patient with previous dacryocystitis developed a mucocele at 6 months requiring excision of the membrane covering the ostium. There were no other early or late complications.…”

“…Continuous wave lasers (CO 2 , KTP, Nd : YAG) have better penetration and provide effective bone removal but are less precise and leave more char 11,13 which may be the reason for early failure in Doyle's study. 17 Holmium : YAG is a pulsed laser and provides more precise ablation, reducing the risk of peripheral damage to nontarget tissues.…”

“…[10][11][12][13][14][15][16] Its role in children is yet to be evaluated and to date there has been only one case-series using the KTP laser with 0% success. 17 We describe our experience with the Holmium : YAG laser using a modified technique in these cases with promising results. Our aims were to evaluate the efficacy, safety, and long-term outcome of this technique in children.…”