Anatomical variants and bilateral lacrimal pathways surgery: avoiding unnecessary surgery.

Success rates (SR) of transcanalicular diode laser-assisted dacryocystorhinostomy (TCL DCR) may be affected by the presence of nasal anatomical variations and additionally by whether or not the pathology is bilateral. The aim is to determine whether it is necessary to perform preliminary nasal anatomical variations surgery and to determine whether bilateral cases may be operated simultaneously. We extracted the patients undergoing simultaneous bilateral TCL DCR and we compared SR across the different groups using ANOVA, Chi-square testing and logistical regression. 159 Lacrimal pathways were operated: 89 unilateral and 35 bilateral. Non-nasal anatomical variations (non-NAV) unilateral surgery returned a success of 72.72%. The mean SR for nasal anatomical variations (NAV) unilateral surgery was 70.1%. The SR for non-NAV bilateral surgery was 60.86%. The mean SR for nasal anatomical variations bilateral surgery was 58.33%. As we identified no significant differences in the SR for NAV and non-NAV patients, we can avoid simultaneous corrective surgery.