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Long-term outcome of transcanalicular microdrill dacryoplasty: a minimally invasive alternative for dacryocystorhinostomy
  1. Natasa Mihailovic,
  2. Alina Friederike Blumberg,
  3. Friederike Rosenberger,
  4. Viktoria Constanze Brücher,
  5. Larissa Lahme,
  6. Nicole Eter,
  7. Ralph-Laurent Merté,
  8. Maged Alnawaiseh
  1. Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
  1. Correspondence to Nataša Mihailovic, Department of Ophthalmology, University of Münster Faculty of Medicine, Albert-Schweitzer-Campus 1, Building D15, Muenster, Nordrhein-Westfalen 48149, Germany; nat.mihailovic{at}


Background/Aim Dacryocystorhinostomy (DCR) remains the gold standard therapy for nasolacrimal duct obstruction (NLDO), but is invasive and does not maintain the physiology of the lacrimal pathway. With transcanlicular microdrill dacryoplasty (MDP), there is a minimally invasive alternative surgical approach. This study aimed to present this modern lacrimal duct surgery technique and to evaluate its long-term success rate in a large study population.

Methods The medical records of 1010 patients with acquired NLDO were retrospectively reviewed. Adult patients who had undergone transcanalicular MDP were included. The evaluation included the following parameters: age, gender, success rate, complication rate, obstruction grade and patient satisfaction. Long-term results regarding patient satisfaction and success rate were evaluated by a telephone survey. Only a complete resolution of symptoms was defined as success.

Results 793 eyes of 576 patients after transcanalicular MDP could be included in the study. The mean follow-up time was 8.7±0.9 years. Initial surgical success rate was 84.0%. At the time of the follow-up, 57.5% (n=229) still had full resolution of symptoms. The mean patient satisfaction with the procedure was 6.9±3.2 out of 10 points. Heavy bleeding occurred in two cases only (0.25%).

Conclusion This is the first study to show the success rate of microendoscopic lacrimal duct surgery after such a long follow-up period and in such a large study population. Transcanalicular MDP is a minimally invasive technique with a very low complication rate and can be used as an alternative procedure before performing more invasive lacrimal duct surgery such as DCR.

  • Lacrimal drainage
  • Treatment Surgery
  • Physiology
  • Anatomy

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  • Contributors NM, MA and NE served as scientific advisors. NM and MA critically reviewed the study proposal. FR, NM, VCB, LL and AFB collected data and R-LM provided and cared for study patients.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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