Lacrimal trephine vs punch in external dacryocystorhinostomy: The surgeon’s choice

Aim: A prospective comparative study to describe the surgical outcomes of external DCR using Kerrisonspunch vs Lacrimal trephine.Materials and Methods: A prospective comparative study involving 56 consecutive patients of agegroup 30-70 years over a period of 3 years who were randomly divided into two Groups. Group 1(n=28)underwent external conventional DCR using kerrisons punch as against group 2 (n=28) where trephine wasused for osteotomy.Result: Procedure success rate among Kerrisons group was 92.85% (26) vs 89.28% (25) in lacrimalTrephine group which is found to be comparable. Overall success rate was 91.07% (51). Need of generalanaesthesia, more bleeding, longer operative time in group 1versus higher chance of nasal mucosal damagein group 2 was noticed. Patients were followed up for six months after surgery.Conclusion: Kerrison punch showed almost comparable success rate to lacrimal trephine group buthigher operating time for external DCR. Lacrimal trephine is relatively easier to perform, requiring shorterduration at skilled hands.Keywords: DCR, Trephine, Lacrimal, Punch.