A comparative study of conventional endoscopic and powered endoscopic dacryocystorhinostomy in a tertiary hospital of Rohtas district, Bihar, India

Background: Dacryocystorhinostomy (DCR) consists of creating an alternative lacrimal drainage pathway to the nasal cavity to restore permanent drainage of the previously obstructed excreting system. The opening is normally made at the level of lacrimal bone. Introduction of the nasal endoscope, interest in endo-nasal DCR increased. The objective of this study was to compare the result and advantage of both conventional endo-nasal and powered endo-nasal DCR regarding patency rate, patient compliance intra-operative and postoperative complications. Methods: In this comparative study of 60 cases for conventional endo-nasal dacrocystorhinostomy and 100 cases of powered endo-nasal dacrocystorhinostomy was performed in the period of May 2017 to March 2018 in the Department of Ophthalmology in conjunction with Department of Otorhinolaryngology, Narayan medical college and hospital Jamuhar Sasaram, Bihar. Level of blockage was diagnosed by lacrimal syringing and probing, Jones dye test and dacrocystography. Surgery was done under local anesthesia except in children and uncooperative patients where general anesthesia was used. For endo-nasal DCR 0 and 30-degree rigid endoscope was used for surgery. Results: Functional success and symptomatic relief were more in powered DCR. Powered endo-nasal DCR surgery was found to be quicker to perform than conventional endo-nasal DCR surgery. Patient satisfaction was significantly higher in the powered endo-nasal DCR group. Complication of powered endoscopic DCR was low. Conclusions: Powered endo-nasal DCR surgery offers a very attractive alternative to the well-established technique than conventional Endo-nasal DCR for the treatment of primary acquired nasolacrimal duct obstruction with better success rates, shorter surgical time and higher patient satisfaction.