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A. Choudhary, J.A. Deans, B.J. Moriarty; Paediatric Laser DCR for Nasolacrimal Duct Obstruction . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5599.
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Aims:To evaluate the efficacy, safety and long–term outcome of paediatric laser dacryocystorhinostomy (DCR) for primary nasolacrimal duct obstruction unresponsive to probing. Methods: Retrospective, non comparative case–note review of all paediatric cases operated between September 2000 and November 2001. Main outcome measures noted were relief of symptoms and peroperative and postoperative complications. Procedure: A fibre optic light, inserted through the canaliculi into the lacrimal sac was visualized endonasally. Nasal mucosa was incised using a phacoemulsification blade. A bony ostium was created with the Holmium:YAG laser and bicanalicular nasal silicone tubes were inserted. Results:5 children with a mean follow up of 17 months (range 10–23 months) and a mean age of 7 years (range 4–9 years) were reviewed. The mean duration of symptoms prior to laser DCR was 4.6 years (range 3–9 years) and all had failed probing. Silicone tubes were used in 4 patients and removed at a mean 6.5 months (range 3–9 months).1 patient developed a mucocele 6 months after the procedure, which was managed by endonasal excision of the mucous membrane. There were no other immediate or late postoperative complications. Complete cure of symptoms was achieved in all patients and was maintained at final follow up. Conclusion:Paediatric laser DCR appears to be a safe and effective procedure for failed probing with a prolonged duration of effect.
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