Effect of Intubation or Anterior Mucosal Flap Suspension on Outcome of External Dacryocystorhinostomy,
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- Category: Vol. 84, March 2016
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Effect of Intubation or Anterior Mucosal Flap Suspension on Outcome of External Dacryocystorhinostomy, MOHAMED M. EL-SAYED, AHMED H.M. AL-DGHAIMY and OSAMA A. AL-SAGHEER
Abstract
Purpose: To evaluate the effect of intubation and anterior mucosal flap suspension on outcome of external dacryocys-torhinostomy.
Methods: This is a prospective, nonconsecutive case series of 30 eyes in 30 patients. The patients were selected from those attending ophthalmology outpatient clinic at Qena University Hospital, South Valley University from January 2012 to January 2014. All will be primary DCRs. All patients will be with documented nasolacrimal duct obstruction before surgery. Cases of chronic dacryocystitis with or without mucocele will be selected.
Data were collected as regards patient demographics, preoperative assessment, operative details, surgical technique, postoperative management, and clinical outcomes.
Ten patients (Group A) underwent DCR without silicon intubation, 10 patients underwent DCR with silicon intubation (Group B), and 10 patients (Group C) underwent DCR without silicon intubation but with anterior mucosal flap suspension and the results obtained were compared.
The mean follow-up time with standard deviation for all three groups was 6 (range 4-8) months.
Our routine preoperative evaluation included a compre-hensive ophthalmic examination, particularly with regard to ocular surface disease, eyelid, and punctum position, and the presence of lacrimal sac mucoceles. To localize the level of lacrimal obstruction. Diagnostic tests included Dye Disap-pearance Test (DDT) as well as probing and irrigation.
Results: Thirty eyes of 30 patients were done and followed-up at Qena University Hospital, South Valley University from January 2012 to January 2014.
Cases were 11 men (36.7%) and 19 women (63.3%) with age range 18-61 and mean 34 years, and randomly divided into 3 Groups (A,B,C) each 10 cases (thirteen cases (43.3%) were done in the right side and 17 cases (56.7%) in the left side). The mean follow-up time for all three groups was 5.2 months (range 4-6) months. A total of 30 procedures were done for PANDO with simple epiphora (9 cases), mucocoele (13 cases), chronic dacryocystitis with positive e regurge (7 cases) or recent dacryocystitis (one case). Duration of symp-toms ranged from 6 months to 2 years (mean 11.6 months).
Conclusion: Dacryocystorhinostomy is the operation of choice to relief epiphora due to nasolacrimal duct obstruction. Lacrimal intubation during DCR and anterior mucosal flap suspension was effective in increasing success rate of DCR.