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WOS: 000337658400027, PubMed ID: 24967205, AIM: To compare bacterial biofilm colonization in lacrimal stents following external dacryocystorhinostomy (EX DCR), endoscopic dacryocystorhinostomy (EN-DCR), and transcanalicular dacryocystorhinostomy (TC-DCR) with multidiode laser. METHODS: This prospective study included 30 consecutive patients with nasolacrimal duct obstruction who underwent EXT-, EN-, or TC-DCR. Thirty removed lacrimal stent fragments and conjunctival samples were cultured. The lacrimal stent biofilms were examined by scanning electron microscopy (SEM). RESULTS: ElevEN-(36.7%) of the 30 lacrimal stent cultures were positive for aerobic bacteria (most commonly Staphylococcus spia'arrniokS and Pseudomonas aeruginosa). However anaerobic bacteria and fungi were not identified in the lacrimal stent cultures. Twenty sevEN-(90%) patients had biofilm positive lacrimal stents. The conjunctival culture positivity after the DCR, biofilm positivity on stents, the grade of biofilm colonization, and the presence of mucus and coccoid and rod shaped organisms did not significantly differ betweEN-any of the groups (P>0.05). However, a significant difference was found whEN-the SEM results were compared to the results of the lacrimal stent and conjunctival cultures (P, Institutional Review Board of Bagcilar Education and Research Hospital, Istanbul, TurkeyIstanbul Bagcilar Training & Research Hospital [1852], Supported by Institutional Review Board of Bagcilar Education and Research Hospital, Istanbul, Turkey (No.1852)