A MODIFIED TECHNIQUE OF EXTERNAL DACRYOCYSTORHINOSTOMY

Abstract

Chronic dacryocystitis usually occurs due to the obstruction of lacrimal passage at the junction of the lacrimal sac
and nasolacrimal duct. The reconstruction of lacrimal passages in such cases can be achieved by several surgical
techniques. We present a modified technique of external Dacryocystorhinostomy (DCR) by suturing of anterior
flaps and excision of the posterior flaps of the lacrimal sac and nasal mucosa and intubation. To present the outcome
of the modified technique of external DCR with anterior flap anastomosis, excision of posterior flaps and intubation.
The study included 30 patients with nasolacrimal duct obstruction who underwent the modified technique of external DCR with anastomosis of anterior flaps only, whereas the posterior flaps were excised. The success rate and
complications were recorded over a follow-up period of 6 months. In this study there was a female preponderance
with a male:female ratio of 1:2.75 The success rate of this modified technique was found to be 93.3%. Intraoperative
complications were bleeding in 13.3% and laceration of the nasal mucosa in 3.3% cases. Two patients had failed
DCR after 12 months. In 1 cases, the obstruction of the bony ostium by granulation tissue and in one case, the sump
syndrome was the cause of failure of DCR. This modified technique of external DCR only simplifies the surgical
procedure without compromising efficacy or safety of the procedure. Anterior flap DCR is a safe, easy to master and
effective surgical procedure.