title: A novel technique to recanalize the nasolacrimal duct with endodiathermy bipolar probe.
abstract: OBJECTIVE
  To evaluate a new approach for recanalization (RC) of nasolacrimal duct obstruction in the treatment of the symptomatic nasolacrimal duct obstruction (NLDO).
  
  
  METHODS
  A prospective, interventional, comparative study in 302 eyes of 209 patients of symptomatic nontraumatic NLDO. Eyes with previous failed surgery were excluded. One hundred and fifty-one eyes underwent RC with 20 G endodiathermy bipolar probe connected to a 7 W diathermy followed by bicanalicular intubation under direct visualization. One hundred and fifty-one eyes underwent standard external dacryocystorhinostomy (DCR). Follow-up was for 24 months and evaluation was done on basis of change in symptoms and lacrimal syringing. Data was analyzed by Chi-square test and unpaired t-test. P value < 0.05 was considered statistically significant.
  
  
  RESULTS
  Success defined as an asymptomatic patient or freely patent syringing was 92.7% (140 eyes) in RC group and 83.44% (126 eyes) in DCR group. Success was significantly more (P ≤ 0.01) in RC than DCR group. Surgical time was significantly less in RC than DCR (P ≤ 0.001). In RC group, RC could not be performed in three eyes and had to be later taken up for DCR. Intubation after RC was not achieved in four eyes; however these eyes had a patent pathway till 24 months. Twenty-two eyes had a premature extrusion of the tube; but the success rate in these (20 eyes) was comparable to the others within the group (P > 0.05). Two eyes in RC and one in DCR group had complications.
  
  
  CONCLUSIONS
  RC with 20 G endodiathermy bipolar probe is a quick, simple, and effective alternative to standard external DCR.
authors.affiliation: Department of Ophthalmology, King Georges' Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Agrawal
authors.forename: Sanjiv K
authors.initials: SK
authors.lastname: Gupta
authors.forename: Vinita
authors.initials: V
authors.lastname: Singh
authors.forename: Saurabh
authors.initials: S
authors.lastname: Agrawal
mesh_terms: D000328:Adult; D003972:Diathermy / Q000295:instrumentation*; D004724:Endoscopy / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000473:pathology*; D011446:Prospective Studies; D007507:Therapeutic Irrigation; D013997:Time Factors; D016896:Treatment Outcome