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To compare surgical success (cosmetic, anatomical &amp; functional) of ‘W’ shaped incision versus tear-trough incision in external dacryocystorhinostomy (eDCR). In a prospective study (November 2018 – March 2020), 61 eyes of chronic dacryocystitis underwent eDCR randomized into group T (30 eyes) &amp; group W (31 eyes). The functional and objective cosmetic assessment was done at 3 months using Munk’s and Devoto’s scores respectively. The subjective cosmetic evaluation was done using a questionnaire. Grades 0–1 were considered the cosmetic and functional success after assessing the respective scores. The patent lacrimal passage was defined as anatomical success. Mean age was 40.1 ± 14.9 years with female preponderance. Intraoperative skin flap button-holing &amp; reversible darkening of their apices were specific complications of Group W. In the early postoperative period, lid edema &amp; epiphora were significantly more in group T ( p  &lt; 0.05). The functional success rate in group T and W was 93.3% and 93.5%, respectively ( p  = 0.53). There was a 100% anatomical success rate in group T whereas 96.8% in group W ( p  = 0.51). The subjective cosmetic success rate was 83.3% in group T and 80.6% in group W ( p  = 0.78) while objective cosmetic success rate was 63.3% and 67.7% in group T and group W, respectively ( p  = 0.72). Surgical success in terms of cosmetic, anatomical &amp; functional outcomes of W-shaped incision were comparable to the conventional Tear trough incision.

Surgical success of ‘W’ shaped incision versus Tear Trough incision in External Dacryocystorhinostomy