Servicio de Oftalmología, Hospital Universitario La Fe, Valencia, Spain.
Servicio de Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain.
Arch Soc Esp Oftalmol (Engl Ed). 2022 Dec;97(12):692-704. doi: 10.1016/j.oftale.2022.06.007. Epub 2022 Jul 22.
the main objective of this work is to review the articles that refer to transcanalicular diode laser dacryocystorhinostomy (TCL-DCR) in acquired nasolacrimal duct obstruction (NLDO), as well as its modifications.
A systematic review of publications related to TCL-DCR of the lacrimal duct from 2000 to March 2021 was carried out in the MEDLINE, EMBASE and COCHRANE LIBRARY databases. The search terms in Spanish and English were: «Endocanalicular laser», dacryocystorhinostomy or «primary DCR-L» or «laser» and «tear ducts».
After subjecting the articles to the inclusion and exclusion criteria, we got 49 articles: 21 retrospective and 28 prospective studies. The bibliometric result obtained guaranteed, for this review, a level C recommendation according to the Scottish Intercollegiate Guidelines Network scale.
Currently, the classic TCL-DCR has lower success rates than its modifications, so we suggest using the latter. We prefer TCL-DCR with IS-MMC or TCDL associated with endoscopy techniques, without being able to opt for any option, since their success rates are very similar. We leave the choice to the discretion of the surgeon, depending on the management skills of endonasal techniques. More studies, with longer follow-up, and better defined criteria are necessary to clarify which is the best TCL-DCR technique.
本研究主要回顾了经鼻内窥镜下泪囊鼻腔吻合术（DCR）联合泪道逆行置管治疗鼻泪管阻塞的疗效。
对 2000 年至 2021 年 3 月期间在 MEDLINE、EMBASE 和 Cochrane 图书馆数据库中发表的与经鼻内窥镜下泪囊鼻腔吻合术相关的研究进行了系统回顾。检索词包括：泪道内窥镜、泪囊鼻腔吻合术、经鼻内窥镜下泪囊鼻腔吻合术、泪道激光治疗。
根据纳入和排除标准，我们共筛选出 49 篇文章：21 篇回顾性研究和 28 篇前瞻性研究。根据苏格兰校际指南网络（ SIGN）标准，本研究推荐强度为 C 级。
目前，传统的经鼻内窥镜下泪囊鼻腔吻合术的成功率低于改良术式，因此我们建议使用改良术式。我们倾向于使用联合丝裂霉素 C（MMC）或钬激光的经鼻内窥镜下泪囊鼻腔吻合术，或联合内镜技术的经鼻内窥镜下泪囊鼻腔吻合术，但不能选择任何一种术式，因为它们的成功率非常相似。术式的选择取决于术者对鼻内镜技术的掌握程度。需要更多的研究、更长的随访时间和更明确的标准来明确哪种经鼻内窥镜下泪囊鼻腔吻合术技术效果最好。
