Evaluation of Different Methods of Posterior Flap Management in External Dacryocystorhinostomy

Evaluation of Different Methods of Posterior Flaps Management in External Dacryocystorhinostomy

The aim of DCR is to form a new, mucosa-lined pathway between the lacrimal sac and the nasal cavity where tears can bypass a lacrimal obstruction and drain directly in the nose. The original external approach was described in 19046. In 1920s, mucosal flap anastomosis was added to the procedure as a modification7, and since then, many new modifications have been made to improve the original procedure.

Aim of The Study

• To compare intraoperative details and postoperative endonasal endoscopic findings and their effects on success rate of external dacryocystorhinostomy with and without anastomosis of posterior mucosal flaps.

Patients and Methods

Study Design: This will be a prospective interventional comparative clinical study. It will include two groups according to the surgical procedure:- Group A: includes 30 eyes that will be treated with external DCR with anastomosis of posterior mucosal flaps .

Group B: includes 30 eyes that will be treated with external DCR with amputation of posterior mucosal flaps .

Study Population:

Study participants will be: 60 eyes undergo external DCR . All patients included in this study will be verbally briefed about the details and the nature of the study & will sign a written consent according to the local Ethics Committee of Minia University Faculty of Medicine. The study will be conducted in Ophthalmology department, Minia university Hospital, Egypt.

Inclusion criteria

• Patients with chronic dacryocystits,
• primary nasolacrimal duct obstruction
• Lacrimal mucocele
• Lacrimal fistula

Exclusion Criteria:

• Recurrent cases.
• Age under 5 years.
• Associated nasal pathology.
• Sever dry eye
• Patients unfit for general anaesthesia