Kareem B. Elessawy
Cairo university, Egypt
Title: Comparative study between conventional external dacryo-cystorhinostomy and transconjunctival dacryocysto-rhinostomy for management of primary acquired naso-lacrimal duct obstruction
Biography
Biography: Kareem B. Elessawy
Abstract
Purpose: To study the efficacy of scarless dacryocystorhinostomy through inferomedial transconjunctival approach in comparison to traditional external dacryocystorhinostomy.
Setting: Tertiary ophthalmic referral centre, Cairo, Egypt.
Design: Prospective randomized comparative interventional case series
Method: It included 40 eyes suffering from nasolacrimal duct obstruction that needed DCR. Patients were randomly divided into two groups. Group A included 20 eyes who underwent conventional DCR surgery via skin incision while group B included 20 eyes who underwent transconjunctival DCR.
Results: Tear meniscus height decreased in both groups after the surgery with more reduction in group A. Patient satisfaction improved in both groups after the surgery with more improvement in group A. In group A, total success was obtained in 19 cases while one case showed partial success. No failures were reported. On the other hand, group B had 17 cases with total success, 2 cases with partial success, and failure in only one case. No major intra-operative complications were encountered in external DCR group. However, complications were reported in 50 % of cases in transconjunctival approach.
Conclusion: External DCR remains the most successful surgery in the management of complete nasolacrimal duct obstruction. While, the trans-conjuntival approach may be considered as a new tool that can be used in specific patients as skin diseases, tendency
for keloid formation or patient preference with comparable results to external DCR. Also, it can be converted into external approach when needed.