Dacryocystorhinostomy Surgery Research Articles

Conventional Dacryocystorhinostomy Versus Pawar’s Implant Dacryocystorhinostomy- A Prospective Study

Purpose: To compare conventional dacryocystorhinostomy (DCR) with Pawar’s intracystic implant dacryocystorhinostomy in terms of surgical technique, complications and success rate for primary acquired nasolacrimal duct obstruction (NLDO).
 Materials and Methods: This is a prospective comparative, nonrandomized, clinical study. It is carried out on 50 cases of primary acquired NLDO. The 50 cases were divide into two groups; Group A consisting of 30 cases that underwent Pawar’s intracystic implant DCR whereas Group B consisting of 20 cases those operated by conventional DCR technique.
 Data regarding demographic profile of patients, mode of presentation, diagnosis, intraoperative variables such as surgical duration, intra- and post-operative complications, hospital stay and causes of failure and final surgical outcome, were analyzed. Clinical success was defined as patent lacrimal system on irrigation (objective) and absence of symptoms (subjective).
 Results: Out of 50 cases 40 (80%) were female and 10 cases (20%) were males. In this study, 39 (78%) cases had chronic dacryocystitis, followed by pyocele/mucocele 5 (10%), chronic dacryocystitis with lacrimal fistula 3 (6%), and previous failed DCR surgery 3 (6%).
 Hemorrhage from nasal mucosa was observed in 9 cases (45%) during conventional DCR surgery and one case (3.33%) in implant DCR. Hemorrhage from angular vein occurred in 1 case (5%) during conventional DCR. Nasal mucosa was disrupted/damage in 8 cases (40%) during conventional DCR. The average operating time in convention DCR is 110.50 minutes while for Pwar’s implant DCR is 27.33 minutes. The commonest post-operative complication of Pawar’s intracystic implant DCR was obstruction of passage found in 4 cases (13.33%). Hypertrophic scar was the most common postoperative complication in 8 cases (40%) in conventional DCR. Success rate of implant DCR at 2 months follow up was 83.33% and at the end of 3 months after management of failed cases of implant DCR was 96.66%. Success rate of conventional DCR at 2 months follow up was 80% and at the end of 3 months after management of failed cases of conventional DCR was 85%.
 Conclusion: The success rate of Pawar’s intracystic implant DCR is comparable with conventional DCR with additional advantages such as easy, quick, minimal intra- and post operative complication and possibility of conventional DCR in future in failed Pawar’s implant DCR.

Comparative Study on Dacryocystorhinostomy (DCR) Surgery with Silicone Tube Intubation and Without Silicone Tube Intubation at Geta Eye Hospital

Comparative Study on Dacryocystorhinostomy (DCR) Surgery with Silicone Tube Intubation and Without Silicone Tube Intubation at Geta Eye Hospital

Results of Single and Double Flap Anastomosis in External Dacryocystorhinostomy Surgery

Background: Dacryocystorhinostomy (DCR) is one of the most common oculoplastic surgeries. In this study, we aimed to compare single and double flap anastomosis results in external dacryocystorhinostomy surgery. Materials and Methods: Between January 2016 and November 2017, 156 patients who underwent external DCR were evaluated retrospectively. All cases were performed under general anesthesia. In the first group, 86 patients (52 female, 34 male) had a double flap external DCR. In the second group, 70 patients (40 female, 30 male) had a single flap external DCR. Results: The mean follow-up period was 18.2±8.6 months in the double flap group and 16.4±5.4 months in the single flap group. The mean age was 48.2±16 in the double flap group and 46.3±17 in the single flap group. The success rate was 96.6% in the double flap group and 95.8% in the single flap group. Conclusion: In our study, there was no difference in surgical success in patients undergoing single and double flap external DCR surgery.

Oral versus single intravenous bolus dose antibiotic prophylaxis against postoperative surgical site infection in external dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction - A randomized study.

Purpose:To compare the efficacy of a single perioperative bolus dose of intravenous antibiotic versus postoperative oral antibiotic prophylaxis for prevention of surgical site infection (SSI) in external dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (PANDO).Methods:This was a prospective randomized controlled study with a noninferiority design. Patients undergoing external DCR surgery were randomized into two groups A and B. Patients in group A received a single bolus dose of intravenous cefazolin 1 g at surgery, whereas those in group B received oral cephalexin 500 mg postoperatively twice a day for 5 days. Allocation concealment was ensured by sequentially numbered opaque sealed envelopes (SNOSEs). Both groups were advised identical postoperative local wound care regimens. Any clinical evidence of SSI at 4 weeks of follow-up in either group was the main outcome measure.Results:In all, 338 patients randomized into two groups of 169 patients each participated in this study. At follow-up of 4 weeks, only one patient in group B developed postoperative SSI. None in group A developed postoperative SSI. Other potential risk factors for postoperative SSI were also analyzed by univariate and multivariate analyses but none achieved statistical significance in either group.Conclusion:Our results demonstrate that a single bolus dose of perioperative intravenous antibiotic offers adequate prophylaxis against postoperative SSI and compares favorably with the more commonly used oral antibiotic prophylaxis in external DCR for PANDO in our population and our practice scenario.

External dacryocystorhinostomy for isolated lacrimal sac rhinosporidiosis - A suitable alternative to dacryocystectomy.

Purpose:To describe the outcome of external dacryocystorhinostomy (DCR) as a suitable alternative to dacryocystectomy (DCT) in cases of isolated lacrimal sac rhinosporidiosis.Methods:This was a retrospective, interventional case series. Institutional review board approval was obtained for the study. The chart review of 13 patients who underwent external DCR surgery for isolated lacrimal sac rhinosporidiosis between July 2012 and May 2018 was performed. Demographic details, clinical presentation, preoperative and intraoperative findings, surgical technique used, postoperative management, surgical outcome and duration of follow up were reviewed for each patient.Results:Thirteen patients were included in the study. Nine (69.2%) were male and four (30.8%) were female. The mean age was 22.1 years (range: 8–46 years). Involvement was unilateral in all cases. The commonest presenting complaint was epiphora with discharge seen in 10 cases (76.9%). An intrasac granuloma was grossly identified intraoperatively in 12 out of the 13 patients. Mean follow up was 26.9 months (range: 1.5–68 months). Till the last follow up, all cases were symptom free and did not have any evidence of recurrence of infection.Conclusion:From this series of cases reported by the authors, external DCR with appropriate precautions to prevent recurrence appears to be a suitable alternative to conventional DCT with excellent long-term outcomes without disease recurrence.

Application of biodegradable collagen matrix (Ologen\u2122) implants in Dacryocystorhinostomy surgeries, a randomized clinical study

BackgroundTo introduce and evaluate the application of Ologen implants in external Dacryocystorhinostomy (DCR) Surgeries.MethodsProspective comparative randomized study was carried out on 60 patients coming to ophthalmology department, Menoufia University Hospitals. Patients included were suffering from primary acquired nasolacrimal duct obstruction with positive regurge test. Patients were randomly enrolled into two groups using alternating choice technique. Group A included 30 patients who had DCR surgery to treat the obstruction with Silicone tubes. Group B included 30 patients had a Dacryocystorhinostomy with Silicone tubes and Ologen implants.ResultsSuccess rates as regard to relief of symptomatic epiphora were 86.7% in group A and 96.7% in group B and time of dye clearance test was 4.5 ± 0.6 min in group A and 3.9 ± 0.4 min in group B with p value 0.353 &0.001 consecutively. Apart from immediate mild post operative hemorrhage that was encountered in 2 cases in group B and 1 case in group A, there were no significant complications in both groups.ConclusionThe current study shows that application of Ologen implants in external DCR surgeries may improve symptomatic epiphora without exposing the patients to more intra-operative or post-operative complications. To the best of our knowledge, the current study is the first one to use Ologen implants in external DCR surgeries. However, the follow-up period was relatively short and the sample size is relatively small and further work is required to verify the effect of Ologen in external DCR surgeries.Trial registrationCurrent Controlled Trials PACTR201711002809215, and the date of registration is 29 November 2017. The trial is Retrospectively registered.

Safety Comparison of Laryngeal Mask Use With Endotracheal Intubation in Patients Undergoing Dacryocystorhinostomy Surgery.

This study will determine the safety of laryngeal mask airway (LMA) compared with endotracheal tube (ETT) in patients undergoing general anesthesia for dacryocystorhinostomy (DCR) surgery. In this retrospective cohort study, intraoperative and postoperative outcomes of patients who underwent DCR at UAB Callahan Eye Hospital using either LMA or ETT were compared. Over a period of 52 months, 429 patients underwent external DCR surgery. An ETT was used in 37 patients and LMA in 392 patients. Baseline patient characteristics and anesthetic management were similar. No documented cases of blood or gastric aspiration occurred in the total cohort. Our study confirmed the findings of others that there is less cardiovascular lability on LMA placement than with ETT intubation. A 30% increase in heart rate from baseline after intubation (ETT 10.8%, LMA 1.8%; p = 0.010) and after incision (ETT 8.1%, LMA 1.8%; p = 0.047) occurred more frequently in the ETT group. Airway management with an LMA was also less difficult compared with an ETT (ETT 5.7%, LMA 0.5%; p = 0.035). The use of an LMA for airway control is safe and effective in patients undergoing general anesthesia for DCR surgery. No events of aspiration occurred with LMA use. Heart rate increase was significantly less in the LMA group. In our opinion, use of an LMA for airway control during DCR surgery is superior to use of an ETT. Airway protection, improved hemodynamics, and less difficulty in placement of the laryngeal airway device are all validated by this study.

A comparative study of conventional endoscopic and powered endoscopic dacryocystorhinostomy in a tertiary hospital of Rohtas district, Bihar, India

<p class="abstract"><strong>Background:</strong> Dacryocystorhinostomy (DCR) consists of creating an alternative lacrimal drainage pathway to the nasal cavity to restore permanent drainage of the previously obstructed excreting system. The opening is normally made at the level of lacrimal bone. Introduction of the nasal endoscope, interest in endo-nasal DCR increased. The objective of this study was to compare the result and advantage of both conventional endo-nasal and powered endo-nasal DCR regarding patency rate, patient compliance intra-operative and postoperative complications.</p><p class="abstract"><strong>Methods:</strong> In this comparative study of 60 cases for conventional endo-nasal dacrocystorhinostomy and 100 cases of powered endo-nasal dacrocystorhinostomy was performed in the period of May 2017 to March 2018 in the Department of Ophthalmology in conjunction with Department of Otorhinolaryngology, Narayan medical college and hospital Jamuhar Sasaram, Bihar. Level of blockage was diagnosed by lacrimal syringing and probing, Jones dye test and dacrocystography. Surgery was done under local anesthesia except in children and uncooperative patients where general anesthesia was used. For endo-nasal DCR 0 and 30-degree rigid endoscope was used for surgery. </p><p class="abstract"><strong>Results:</strong> Functional success and symptomatic relief were more in powered DCR. Powered endo-nasal DCR surgery was found to be quicker to perform than conventional endo-nasal DCR surgery. Patient satisfaction was significantly higher in the powered endo-nasal DCR group. Complication of powered endoscopic DCR was low.</p><p class="abstract"><strong>Conclusions:</strong> Powered endo-nasal DCR surgery offers a very attractive alternative to the well-established technique than conventional Endo-nasal DCR for the treatment of primary acquired nasolacrimal duct obstruction with better success rates, shorter surgical time and higher patient satisfaction.</p><p class="abstract"> </p>

Avoiding dacryocystorhinostomy in cases of epiphora caused by inferior meatus obstruction.

To determine the role of inferior meatus pathologies as an underdiagnosed cause of epiphora. This study was conducted in the oculoplastic institution of Tel Aviv medical center-a regional referral center. A retrospective review of files of patients presenting to the lacrimal clinic with nasolacrimal duct obstruction between October 2010 and September 2016. Cases in which a pathology of the inferior meatus was identified and treated are presented in this article. During this time frame, we preformed 186 endoscopic dacryocystorhinostomy surgeries. Out of those, eight patients (4.3%) were diagnosed and treated for pathology causing an obstruction of the inferior meatus. Seven of our patients were females; the mean age was 24 years. A wide range of pathologies were found: cysts, dacryoliths, membranes obstructing the inferior meatus, and concheal obstruction. All patients went through endoscopic treatment targeted at the cause of obstruction. During follow-up (average 35 months) only two patients remained symptomatic and were referred for an endonasal endoscopic dacryocystorhinostomy. Inferior meatus obstruction is an underdiagnosed cause of epiphora. Multiple pathologies may co-exist in the same patient. In select cases of NLDO, diagnosis and treatment can be done endoscopically, avoiding the need for dacryocystorhinostomy.

Transcanalicular Diode Laser-Assisted Revision Surgery for Failed Dacryocystorhinostomy With or Without Distal or Common Canalicular Obstruction.

To report the outcomes of transcanalicular diode laser-assisted revision surgery for failed dacryocystorhinostomy with/without distal or common canalicular obstruction. The medical records and recorded videos of consecutive transcanalicular diode laser-assisted revision surgeries performed for failed dacryocystorhinostomy between May 2011 and May 2015 were reviewed. Cases of unavailability of video and cases lost to follow up after surgery were excluded from the study. With respect to the level of obstruction, lacrimal drainage systems were divided into Group 1 (obstruction at the level of the ostium) and Group 2 (obstruction at the level of the distal or common canaliculus). Data associated with anatomical and functional success were analyzed. Revision dacryocystorhinostomy surgeries were performed on 68 patients during the study period. Transcanalicular diode laser-assisted revision surgeries were performed on 48 eyes of 39 patients. Mean follow-up period after revision surgery was 13.3 ± 12.6 months. Overall, anatomical success rate was 83.3% (40/48) and functional success rate was 68.8% (33/48). Anatomical success rates and functional success rates in the 2 groups showed no significant difference (80.0% [24/30] vs. 86.7% [13/15], p = 0.699; 70.0% [21/30] vs. 66.7% [10/15], p = 1.000, respectively). Transcanalicular diode laser-assisted revision surgery may be an alternative technique for failed dacryocystorhinostomy. Distal or common canalicular obstruction did not affect the outcomes of revision surgeries.

A Study of Efficacy of Intraoperative Application of Mitomycin-C in Endoscopic Dacryocystorhinostomy

Introduction
 Common cause for failure of endonasal dacryocystorhinostomy is closure of the intranasal ostium usually due to granulation tissue formation. Attempts have been made to improve the success rate of lacrimal surgery by using different methods like using balloon catheters, lasers and antimetabolites. This study aims to see change in success rate with and without the use of using Mitomycin-C in endonasal Dacryocystorhinostomy (DCR) surgery.
 Materials and Methods
 Sixty patients of acquired chronic dacryocystitis with nasolacrimal duct blockage, in the age group of 11-50 yrs were taken for study. Patients were alternatively divided into two groups A & B (30 patients in each group). Endoscopic dacryocystorhinostomy with Mitomycin-C application was performed in Group A and without Mitomycin-C application in Group B patients. Subjective assessment for symptomatic improvement and objective analysis obtained from results of syringing. The result data was subjected to Student’s t test and x2analysis.
 Result
 Age of patients varied from 11 to 50 yrs. The male to female ratio was 7:8 in group A while 2:3 in group B. The commonest age group was between 21 -30 years in both the groups. After 12 month follow up the success rate was 93% in both the groups. The results between the groups were found to be statistically not significant (p>0.05).
 Conclusion 
 Mitomycin C was used in this study to assess its efficacy in improving the results of endoscopic DCR. Mitomycin C did not have significant effect on the outcomes of endoscopic DCR surgery for chronic dacryocystitis.

To Study the Effect of Silicone Tube Intubation with and without Mitomycin C in Revision of Failed Dacryocystorhinostomy Surgery

To Study the Effect of Silicone Tube Intubation with and without Mitomycin C in Revision of Failed Dacryocystorhinostomy Surgery

Orbital Pseudotumor Initially Presented as Chronic Sinusitis: A Case Report

Idiopathic orbital pseudotumor, is defined as a benign, non-infective lesion characterized by orbital inflammatory process. A 73-year-old man, with a 1 year history of severe headache and unilateral left-sided chronic pan-sinusitis without orbital involvement underwent functional endoscopic sinus surgery (FESS) surgery due to sinusitis recurrence. Also Dacryocystorhinostomy (DCR) surgery and re-surgery of sphenoid sinus and middle turbinecomy were conducted. About 5 months later, patient presented with ocular pain, diplopia and reduced left eye movements. He underwent surgery and biopsy was conducted for histopathology and immunohistochemistry (IHC) and their reports confirmed the diagnosis of orbital pseudotumor. The initial symptoms did not start from orbit, interestingly. Notably, one of the differential diagnoses of unilateral chronic sinusitis can be orbital pseudotumor.

Собственный опыт профилактики рецидивов дакриоцистита при наружной дакриоцисториностомии

Purpose: to evaluate the effectiveness of integrated methods of prevention dacryocystitis recurrences in external dacryocystorhinostomy. Materials and methods. 120 patients (120 eyes) with dacryocystitis, 85 women and 35 men, aged 21 to 75, were divided into 2 groups. The main group of 60 patients (60 eyes, 40 women and 20 men) whose mean age was 65 ± 12.5 years were subjected to external dacryocystorhinostomy with the use of a specially modified device, trepanation fraise, for the formation of the bone window and a binary stent to ensure the tamponade of a formed anastomosis. The control group was formed by the remaining 60 patients (60 eyes, 45 women and 15 men) with a mean age of 69 ± 16.2 years, who underwent regular operations according to Addeo Toti. Results. In the main group, recuperation was noted in 49 cases (82 %) and improvement in 10 cases (17 %). 1 case (1.6 %) showed a recurrent dacryocystitis. In the control group, recuperation was achieved in 38 cases (63.3 %), improvement in 17 cases (28.3 %) and the recurrence of the condition occurred in 5 cases (8.3 %). Conclusion. The proposed method enables an effectiveness increase of external dacryocystorhinostomy surgeries. For citation: Shikhunov D.Sh., Aliev A-G.D., Aliev A.A.-G., Abdulaev A.B.. The experience of prevention of dacryocystitis recurrences in external dacryocystorhinostomy. Russian ophthalmological journal. 2018; 11 (1): 30-4. doi: 10.21516/2072-0076-2018-11-1-30-34 (In Russian).

The outcomes of 326 external dacryocystorhinostomy operations in children with dacryostenosis - 30-year experience of an oculoplastic surgeon.

To report demographic features and surgical outcomes of 320 children undergoing external dacryocystorhinostomy for dacryostenosis. We performed a retrospective evaluation of the records of patients aged <16 years who underwent external dacryocystorhinostomy. Patient demographic features and success rates of the operations were analyzed from the data records. Children with <12-month follow-up were not enrolled in the study. We identified 326 operative records of 320 children (162 [50.6%] girls and 158 [49.4%] boys) who underwent external dacryocystorhinostomy with a mean follow-up of 26.03 ± 11.11 months. Overall, we evaluated 116 (35.6%) cases of congenital nasolacrimal duct obstruction. Our series demonstrated a 99.4% success rate for external dacryocystorhinostomy. External dacryocystorhinostomy in children has a high success rate if performed by an experienced oculoplastic surgeon.

Factors Affecting the Success Rate of External Dacryocystorhinostomy at B. P. Koirala Institute of Health Sciences, Dharan, Nepal

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). Binary logistic regression models were used to investigate the association of the surgical outcome with various predicting variables.ResultsThe success rate of the external dacryocystorhinostomy was 78.09%. Factors studied were: age, with a range of 2-81 years; duration of symptoms with a range of 1-84 months; and gender of the patients. The intra-operative factors studied were use of silastic tube, types of flap, and osteotomy size. Among these factors, the duration of symptoms and osteotomy size had significant association with the outcome of the surgery p&lt;0.05.ConclusionOur study yielded high success rate in patients with shorter duration of watering of eyes and larger osteotomy size during surgery. Hence, a larger osteotomy size and early intervention is recommended for better surgical outcome. Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 196-200

External Dacryocystorhinostomy; Success Rate and Causes of Failure in Endoscopic and Pathologic Evaluations

External dacryocystorhinostomy (DCR) is the method of choice to treat nasolacrimal duct (NLD) obstruction and the other approaches are compared with it, with a failure rate of 4% to 13%. The current study aimed to assess the causes of failure in external DCR by postoperative endoscopic and pathological evaluation. The current retrospective cross sectional study followed-up113 patients with external DCR and silicone intubation for three months. Silicone tubes were removed after the third months. Failure was confirmed based on the clinical findings and irrigation test. Paranasal sinus computed tomography (CT) scanning, and endoscopic and pathological evaluations were performed in the failed cases. Totally, 113 patients underwentexternal DCR. The patients included 71 females and 42 males. The mean age of the patients was 55.91 years; ranged from 18 to 86. Epiphora was the most common complaint before surgery (90.3%). Clinically, epiphora continued in 17 cases (15%), of which 94.11% had at least one sinus CT abnormality and 82.35% had at least one endoscopic abnormality. The most common endoscopic findings were deviated septum (70.6%), scar tissue (52.94%), concha bullosa (46.9%), septal adhesion (47.05%), enlarged middle turbinate (41.2%), and sump syndrome (11.7%). The failure was significantly associated with the chronicity of the initial symptoms (P-value=0.00). Pathologically, there were significant relationship amongst the failure rate, scar formation, and allergic rhinitis (P-values =0.00 and <0.05, respectively). Preoperative endonasal evaluation and consultation with an otolaryngologist can improve surgical outcomes and help to have a better conscious to intranasal abnormalities before external DCR surgery.

Indian survey on practice patterns of lacrimal & eyelid disorders (iSUPPLE): Report 3 – Cataract and nasolacrimal duct obstruction

AimTo assess the practice patterns pertaining to pre-cataract screening for nasolacrimal duct obstruction (NLDO) among oculoplastic surgeons in India. The survey was aimed at obtaining data on the current screening and treatment strategies for NLDO and the interval between lacrimal surgery and subsequent cataract surgery. MethodsAn online survey was sent to all members of Oculoplastic Association of India. All valid responses were tabulated and analyzed. ResultsMajority of the respondents (92%) felt that nasolacrimal duct patency should be checked prior to performing cataract surgery: 59.6% felt that checking for regurgitation on pressure over the lacrimal sac (ROPLAS) was sufficient and 32.6% preferred to perform lacrimal irrigation to check for NLD patency. Dacryocystorhinostomy (DCR) was the preferred surgery for NLDO thus detected. The preferred interval between a DCR and subsequent cataract surgery was 4weeks (48.9%). A small minority (7.9%) of the respondents felt that pre-cataract screening for NLDO was not required. Also, a small but significant number (12.6%) felt that no treatment was required for NLDO in such patients and that to could go ahead with cataract surgery even in the presence of coexisting NLDO. ConclusionsThere is a general agreement on the need for pre-cataract screening for NLDO and a majority indicated that checking for ROPLAS was sufficient. Most surgeons prefer to perform a DCR in cases of NLDO and wait for 4weeks before intraocular surgery. There is however, a lacuna in the literature on guidelines regarding the optimal interval between lacrimal surgery and subsequent intraocular surgery.

Increased Concomitant Nasal Procedure Frequency in Bilateral Endoscopic Dacryocystorhinostomy.

The etiology of primary nasolacrimal duct obstruction (NLDO) is unknown, and the disease may exist bilaterally in a small number of patients. Dacryocystorhinostomy (DCR) surgery is the recommended treatment for these patients, but concomitant nasal pathologies are believed to be related to decreased surgical success. The authors aim to assess the concomitant required nasal surgical procedure frequency for endoscopic surgical access retrospectively in bilateral and unilateral NLDO patients. Twenty-eight patients who underwent bilateral endoscopic DCR simultaneously and 30 patients who underwent unilateral endoscopic DCR were enrolled in this retrospective study. Required concomitant nasal procedure frequency was recorded. In the bilaterally applied DCR group, septoplasty, partial midline turbinectomy, and inferior nasal concha submucosal resection rates were 16 (57.1%), 5 (17.8%), and 3 (10.7%) patients, respectively. Septoplasty and concha bullosa resection were performed simultaneously in 2 patients. Also, uncinectomy was performed with septoplasty in 1 patient. The concomitant nasal surgery rate was 22 of 28 patients (78.6%). On the other hand, in the unilaterally applied DCR group, septoplasty, partial midline turbinectomy, and inferior nasal concha submucosal resection rates were 5 (16.7%), 1 (3.3%), and 2 (6.7%) patients, respectively. Both septoplasty and concha bullosa resection were done in 1 patient. Uncinectomy was performed on 1 (3.3%) patient. A concomitant surgery rate was observed in 8 of 30 patients (26.7%). Nasal pathology, which requires surgical intervention, is seen much more frequently in bilateral than in unilateral NLDO patients.

Functional Outcome in Primary Nasolacrimal Duct Obstruction after Successful External Dacryocystorhinostomy Surgery

Aim: To assess the functional outcomes of external dacryocystorhinostomy(DCR) surgery in symptomatic patient with primary nasolacrimal duct obstruction .Settings and Design: Prospective, clinical interventional studyMethods: This study was conducted in 50 consecutive (50 eyes) patients of Primary Acquired Nasolacrimal Duct Obstruction admitted in a tertiary eye care centre. Functional outcome comprises of symptom improvement which include absence of epiphora, improvement in vision, routine work, occupational work, mood, embarrassment. Assessment was done by pre and post-operative questionnaires at 2 ,6 and 12 months postoperatively.. Anatomic success was assessed by Lacrimal syringing , Fluorescein dye disappearance test(FDDT) and endoscopic view of osteotomy. Statistical significance between preoperative and postoperative symptoms (Functional outcome assessment) was analysed using McNemars testResults: Postoperatively, marked improvement in subjective symptoms i.e. difficulty in vision (93.5%), routine work (95.6%),occupational work (95.8%),mood(95%) and embarrassment (94%) was seen with anatomic success of 96%.Conclusions: In PANDO population, symptoms bother patient significantly. However, successful DCR surgery has a beneficial effect on the patient physical and social health thus changing the quality of life of patients markedly.