Open AccessChange to win - flapless external dacryocystorhinostomy (DCR)
Author(s) -
Ravi Ranjan,
Bikramganj Awadh Medicare,
Rupam Kumari,
Santhosh Kumar,
Awadh Medicare Consultant
Publication year - 2020
Publication title -
tropical journal of ophthalmology and otolaryngology of siddharth health research and social welfare society
Language(s) - English
Resource type - Journals
ISSN - 2581-4907
DOI - 10.17511/jooo.2020.i08.04
Subject(s) - medicine , dacryocystorhinostomy , surgery , lacrimal sac , nasolacrimal duct obstruction , endoscope , mitomycin c , nasolacrimal duct , anastomosis , endoscopy , nasal cavity
Nasolacrimal Duct obstruction (NLDO) is a common ophthalmic problem and theusual Treatment is Dacryocystorhinostomy (DCR), either external or endonasal. This study aims toevaluate the success of external DCR with neither anterior nor posterior flaps with Mitomycin c(MMC) syringing on the 5th post-operative day (early proliferative phase of wound healing). It wasshown in the present study that a comparable good result can be achieved without tedious flapsmaking and anastomosis. Material and Methods: It is a retrospective, non-comparativeobservational Case series study done from March 2011 to August 2019. A total of 2165 patientswere included in this study qualifying inclusion criterion. 8 to 10 mm Arruga’s bone trephine wasused to make osteum in lacrimal bone and passage in the nasal mucosa. The anterior margin of thelateral side of the remaining sac was sutured to the subcutaneous tissue of the medial side adjacentto the nasal osteotomy. Syringing with 1 ml of 0.4 mg/ ml MMC was done in the newly formedpassage on the 5th post-operative day. These patients were followed up for one year. The successcriteria were symptomatic relief from epiphora subjectively. Objectively a patent nasolacrimal ductupon syringing and Nasal endoscopy. Results: 2136 (out of 2165) patients' eyes treated with thisprocedure showed resolution of epiphora with a success rate of 98.66%. Conclusion: The currentstudy suggest that DCR without flap making is an effective and easy procedure in the managementof NLDO obstruction and flap making is a futile step in the procedure as it has no impact on theoutcome.