Aesthetic External Dacryocystorhinostomy (original) (raw)
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The cosmetic outcome of external dacryocystorhinostomy scar and factors affecting it
Indian Journal of Ophthalmology
External dacryocystorhinostomy (Ex-DCR) is among the common oculoplastic surgeries and is considered as the gold standard for surgical correction of primary acquired nasolacrimal duct (NLD) obstruction. [1,2] It is a highly successful procedure with a success rate more than 90% quoted in different series since it was first described by Toti in 1904 and modified by Dupuy-Dutemps in 1921. [2-4] The inevitable downside of Ex-DCR has been an external skin scar, which has led to the evolution of several nonincisional techniques with variable success rates. [5-9] There have been few studies that have addressed the visibility of Ex-DCR scars, which has been reported to vary from 9% to 33%. [10-12] There is an increasing demand on an oculoplastic surgeon from their patients and referring physicians to do endonasal surgery. Young and middle-aged patients are increasingly aware of the endonasal approach and are easily dissuaded by a skin scar. While we wait for endonasal procedures to evolve and achieve comparable success rates, an external approach DCR that can successfully hide the scar is highly desirable. [13] It is important for an oculoplastic surgeon to know the factors that may have an influence on the Ex-DCR scar. In this study, we aimed to evaluate the cosmetic outcome of Ex-DCR among Egyptian patients and to identify the factors affecting it. Patients and Methods This prospective randomized interventional study included forty patients (forty procedures) who underwent Ex-DCR over a period of 18 months (July 2013 to December 2014). Patients were subjected to full ophthalmological evaluation and lacrimal system examination including fluorescein dye disappearance test, regurgitation test, diagnostic probing, and irrigation. Patients with punctal or canalicular pathology, acute dacryocystitis, or previous lacrimal surgery were excluded from the study. The study adhered to the principles of the Declaration of Helsinki and has been approved by the Institutional Ethical Committee. Data about the patients' age, sex, and skin complexion (fair skinned or dark skinned) were collected. The patients were randomly distributed between 2 age and sex matched groups, each one including twenty patients. In Group A patients
Transconjunctival dacryocystorhinostomy: Long term results
Saudi Journal of Ophthalmology, 2014
Purpose: To evaluate the outcomes of transconjunctival dacryocystorhinostomy (TRC-DCR) surgery in patients with epiphora due 12 to primary acquired nasolacrimal duct obstruction (PANDO) at second year follow-up. 13 Methods: In this retrospective, interventional study, 33 eyes of 29 patients, with epiphora due to PANDO, are included. Lower 14 eyelid conjunctiva is incised at vestibulum inferomedially to access the lacrimal sac and nasal mucosa. Bone is perforated with burr 15 and rongeurs and saccal and nasal flaps are anastomosed. Conjunctival wound edges are apposed and left unsutured. Intraoper-16 ative difficulties, surgical time and complications are noted. Average follow-up time was 2 years. Anatomical success was defined 17 as patent lacrimal passages upon irrigation and functional success was defined as relief of epiphora. 18 Results: In nineteen (57.6%) eyes the surgeries were completed with the anterior and the posterior flaps sutured. In eight eyes 19
External dacryocystorhinostomy: A two-year review
Asian Journal of Ophthalmology, 2018
Background: Dacryocystorhinostomy (DCR) is the treatment of choice for nasolacrimal duct obstruction. Despite the emergence of new techniques such as endoscopic DCR, external DCR is still the criterion standard in primary cases. Aim: To analyse the epidemiological data, surgical technique, success rate, and complications of patients who underwent external DCR in Hospital Selayang from January 2015 to December 2016. Method: Retrospective case series. Results: A total of 21 eyes of 20 patients who underwent external DCR from January 2015 to December 2016 were identified and reviewed. There were 15 females (75%) and 5 males (25%). Age ranged from 5 to 75 years old, with a median age of 56 years old (IQR 23). Twelve patients presented with epiphora while eight patients presented with symptoms of dacryocystitis. One case was congenital, two were secondary nasolacrimal duct obstruction and the rest were primary nasolacrimal duct obstruction. All patients underwent external DCR under gener...
Canadian journal of ophthalmology, 2019
Objective: To determine whether the history of chronic conjunctivitis increases the likelihood of epiphora after an external dacryocystorhinostomy (Ex-DCR) and to elucidate other factors that may affect the prognosis of this surgery. Methods: This is a retrospective case-controlled study. Patients who had epiphora after an Ex-DCR were compared with patients who did not present epiphora. Medical history of conjunctivitis, use of antiglaucomatous drops, rhinitis, and nasal pathology were evaluated. Results: A total of 129 adult patients undergoing external DCR were evaluated, of which 73% had decreased tearing. Forty-five percent of the patients who continued with epiphora had a history of conjunctivitis, compared to the 20% of those who did not (p = 0.003). At the same time, the 20% of those who continued with epiphora had a history of rhinitis compared to the 8% of those who did not (p = 0.043). Conclusion: Patients with a history of chronic conjunctivitis are less likely to improve the epiphora after performing an Ex-DCR. We consider that it is important to evaluate this antecedent before surgery.
Birat Journal of Health Sciences, 2017
IntroductionAny disturbance to the normal ouVlow of tears through the nasolacrimal passage causes overflow known as epiphora. The clinical symptoms of epiphora range from mild dribble to the continuous ouVlow of tears. Watering of eyes caused by the nasolacrimal drainage obstruction is managed by surgery. One of the many surgeries to treat this is external dacryocystorhinostomy.ObjectiveThe objective of this study was to evaluate the success rate of external dacryocystorhinostomy as well as factors affecting it.MethodologyThis is a retrospective cross-sectional study, conducted in the Department of Ophthalmology, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan with the approval of Institutional Review Committee, BPKIHS. The medical records of patients who underwent external Dacryocystorhinostomy surgery from April 2011 to April 2016 at BPKIHS were retrospectively reviewed. Statistical analysis was performed using SPSS for windows, version 11.5 (SPSS Inc., Chicago, IL)....