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Inferior flap design may be effective modification to external DCR

Ophthal Plast Reconstr Surg. 2010;26(4):277-280.

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Inferior flap anastomosis helps to simplify external dacryocystorhinostomy and produces comparable success rates as the conventional procedure, a study showed.

In the prospective study, 33 patients who were between the ages of 12 and 65 years and had nasolacrimal duct obstruction underwent external dacryocystorhinostomy (DCR) with the modified flap design.

While three patients developed postoperative epiphora, none of the patients had signs or symptoms of epiphora at the end of the follow-up period (mean: 15.6 months). Researchers defined procedural success as amelioration of epiphora and anatomic patency.

"We anastomosed inferiorly hinged lacrimal and nasal mucosal flaps, which we think is a unique and effective variant of flap anastomosis," the study authors said. "Although the number of patients included in the study is relatively small, our study suggests that inferior flap design in external DCR has satisfactory outcomes. Further studies including greater numbers of patients are warranted to confirm the outcomes and to determine whether this modification supplies an efficacious alternative in DCR surgery."