Outcomes of posterior lacrimal sac approach in endoscopic dacryocystorhinostomy: Review of 35 cases

Background: The purpose of this study was to describe the posterior lacrimal sac approach in endoscopic dacryocystorhinostomy (DCR) performed at our institute and report perioperative results achieved with this procedure. Methods: A prospective clinical study was performed of 35 adult patients with nasolacrimal duct obstruction who underwent posterior lacrimal sac approach DCR from March 1998 to May 2005. Follow-up period ranged from 13 to 30 months (average, 17.5 months; SD, 6.8 inonths). '' Surgical success '' was defined as complete relief of epiphora and patent surgical ostium on endoscopic assessment. Results: Surgical success was achieved in 30135 (85.7%) patients after the primary surgery. Of 5 unsuccessful patients who complained of occasional epiphora, 4 patients had formed stenosis and I patient had granulation around the surgical opening, and all had revision surgery. Four of 5 (80.0%) patients achieved surgical success. Thus, including the result Of revision surgery, 34135 (97.1%) patients were successful. Conclusion: Posterior lacrimal sac approach in endoscopic DCR has several advantages: good sac accessibility, a low complication rate, and a relatively high success rate. Therefore, the posterior lacrimal sac approach appears to offer a useful alternative approach for the surgical treatment Of nasolacrimal duct obstruction.