The long-term outcome of the modified external dacryocystorhinostomy

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Abstract


External dacryocystorhinostomy (DCR) is still the gold standard procedure for treating nasolacrimal duct obstruction or chronic dacryocystitis.

Purpose: to evaluate the long-term functional outcome of the modified technique of external dacryocystorhinostomy.

Materials. 55 patients (61 eyes) with lacrimal drainage system disorders who underwent the modified technique of external DCR between 2013-2015 were involved in the study. In this modified procedure of external DCR, anastomosis was created by suturing only anterior flaps of the lacrimal sac and nasal mucosa and excision of the posterior flaps. The mean age of the patients was 65.8 ± 12.38 years (range, 27-87 years), including 47 females and 8 males. The mean follow-up time was 19.4 ± 6.9 months (range, 4-33 months). The success rate was recorded during the follow-up period. Cosmetic result of surgery was interpreted by the patients.

Results. Criteria for surgical success were defined as no or minimal intermittent epiphora, no reflux on lacrimal irrigation postoperatively and a positive functional dye test. The modified external DCR with only anterior flap anastomosis had a success rate of 93.4%. 4 patients (6.6%) had recurrence of epiphora and not patent lacrimal system to irrigation. In our study, the operation time of DCR varies from 25-40 minutes. After surgery 15 of 55 patients (27.3%) described the incision scar as “invisible” and 3 of 55 patients (5.5%) graded it as very visible, hypertrophic scar. Five of 55 patients (9.1%) were not satisfied with the appearance of the incision.

Conclusion. The present study concludes that modified external DCR with anterior flaps anastomosis only is a simple, less time consuming surgical technique that is easy to perform and the outcome is comparable to conventional DCR.


Vyacheslav V Rakhmanov

Author for correspondence.
rakhmanoveyes@yandex.ru
Pavlov First St Petersburg State Medical University
Russian Federation, Saint Petersburg, Russia

candidate of medical science, assistant professor. Ophthalmology Department

Vitaly V Potemkin

potem@inbox.ru
Pavlov First St Petersburg State Medical University
Russian Federation, Saint Petersburg, Russia

candidate of medical science, associate professor

Elena V Meshveliani

lena_vm@inbox.ru
Pavlov First St Petersburg State Medical University
Russian Federation, Saint Petersburg, Russia

resident. Ophthalmology Department

Alyona A Pirgunova

cvcv4698@yandex.ru
Pavlov First St Petersburg State Medical University
Russian Federation, Saint Petersburg, Russia

resident. Ophthalmology Department

Aisa S Alchinova

aalchinova@mail.ru
Pavlov First St Petersburg State Medical University
Russian Federation, Saint Petersburg, Russia

resident. Ophthalmology Department

Ksenia Y Morina

ksushka.90@mail.ru
Pavlov First St Petersburg State Medical University
Russian Federation, Saint Petersburg, Russia

resident. Ophthalmology Department

Elena V Ageeva

ageeva_elena@inbox.ru
Pavlov First St Petersburg State Medical University
Russian Federation, Saint Petersburg, Russia

resident. Ophthalmology Department

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