External dacryocystorhinostomy: do we really need to repair the posterior flap?

Katuwal, Sulaxmi, Aujla, Jaskirat Singh, Limbu, Ben, Saiju, Rohit and Ruit, Sanduk (2013) External dacryocystorhinostomy: do we really need to repair the posterior flap?. Orbit, 32 2: 102-106. doi:10.3109/01676830.2013.764451

Author Katuwal, Sulaxmi
Aujla, Jaskirat Singh
Limbu, Ben
Saiju, Rohit
Ruit, Sanduk
Title External dacryocystorhinostomy: do we really need to repair the posterior flap?
Journal name Orbit   Check publisher's open access policy
ISSN 0167-6830
Publication date 2013-04
Year available 2013
Sub-type Article (original research)
DOI 10.3109/01676830.2013.764451
Open Access Status
Volume 32
Issue 2
Start page 102
End page 106
Total pages 5
Place of publication London, United Kingdom
Publisher Informa Healthcare
Collection year 2014
Language eng
Subject 2731 Ophthalmology
Formatted abstract
Purpose: This study aims to compare a simplified technique of external dacryocystorhinostomy (DCR), where the posterior flap is excised, with the more traditional approach of double flap repair.

Methods: A prospective, comparative, single surgeon, single centre clinical trial was conducted of eighty-three patients who received external DCR, with either anterior and posterior flap anastomosis (Group A), or anterior flap anastomosis and excision of the posterior flap (Group B), in a tertiary referral hospital in Nepal. Patients with nasolacrimal duct obstruction and epiphora were assigned to one of two groups. Follow up was a minimum of 6 months for inclusion in the study. Success was defined objectively by irrigation of the puncta without regurgitation and subjectively by the absence of epiphora or discharge.

Results: The overall success rate of external DCR was 89.2%, after a mean follow up of 13.5 ± 2.2 months. There was no difference in success between the two groups (p-value = 0.73), with 90.7% success in Group A and 87.5% in Group B. The frequency of complications was not statistically different between Groups A and B (p-value = 0.79).

Conclusions: Excision of the posterior flap and anastomosis of only the anterior flap is not disadvantageous to the outcomes of external DCR surgery when compared with the more traditional approach of anastomosis of both flaps. We believe this simplified procedure can be implemented as the standard technique for external DCR, particularly in developing nations such as Nepal.
Keyword Dacryocystorhinostomy
Nasolacrimal duct obstruction
Posterior flap excision
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
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