Abstract
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 general anaesthesia. Silicone tube were inserted in 21 eyes, of which all were removed 3 months after the surgery except one patient whom had his tube dislodged accidentally. The overall success rate was 90.5% (n = 19), which was defined as no or minimal intermittent epiphora or no reflux on lacrimal irrigation at 12 months postoperative. There was one patient who had a cerebrospinal fluid leak treated successfully with intravenous antibiotics.
 Conclusion: The surgical success rate for external dacryocystorhinostomy was comparable to that of the global success rate of external DCR. This is attributed to the application of surgical technique such as anterior suspended flap modification and posterior flap excision.
Highlights
Nasolacrimal duct obstruction is a common condition encountered by ophthalmologists and oculoplastic surgeons
A retrospective analysis of patients referred to the Oculoplastic team, Department of Ophthalmology, Hospital Selayang (Kuala Lumpur, Malaysia) that had undergone external DCR from January 2015 to December 2016 were identified
External DCR was performed under general anaesthesia
Summary
Nasolacrimal duct obstruction is a common condition encountered by ophthalmologists and oculoplastic surgeons It generally affects two age groups: infants and adults older than 40 years old, especially female. Dacryocystorhinostomy (DCR) is the treatment of choice for nasolacrimal duct obstruction It creates anastomosis between the lacrimal sac and nasal cavity through the bony ostium. Despite the emergence of new techniques such as endoscopic DCR, external DCR is still the criterion standard in primary cases, with a success rate of 80-95%.1. 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. This is attributed to the application of surgical technique such as anterior suspended flap modification and posterior flap excision
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