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Successful External DCR: Factors to Consider for Optimal Results

Learn about external dacryocystorhinostomy (DCR) as the gold standard for NLDO, factors affecting surgery success, inclusion/exclusion criteria, surgical procedures, postoperative complications, and success rates with silicon intubation.

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Successful External DCR: Factors to Consider for Optimal Results

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  1. DR SALINS EYE HOSPITAL VELEMEGNA GOOD NEWS SOCIETY-BIDAR,KARNATAKA

  2. Successful external DCR- Factors to be considered Dr Sybil Meshramkar Dr Praveen Sadanand

  3. External DCR – gold standard for NLDO compared to endonasal or transcanalicular DCR • Aim – consider factors affecting success of DCR • Inclusion criteria – chr.dacryocystitis, mucocele, epiphora. • Exclusion criteria - < 10yrs, nasal pathology, lid laxity, canalicular obstruction.

  4. Lacrimal drainage disorders • Chronic dacryocystitis (59) • Lacrimal fistula (1) • Mucocele (1) • Previous failed DCR(1)

  5. Discharge in eyes

  6. Age and sex distribution

  7. Surgical procedure • Large osteotomy • Suturing of anterior flaps • Silicon tube intubation

  8. Anterior Nasal Mucosal Flap

  9. Sac Mucosal Flap

  10. Silicon Intubation Tube

  11. Silicon Tube Knotted

  12. Knotted Silicon Tube Outside The External Nares

  13. Nasal and Sac Mucosal Sutured

  14. Silicon Intubation Tube Seen In The Puncta

  15. Intraoperative complications

  16. Intraoperative bleeding

  17. Late postoperative complications

  18. Post operative complications • Scar very faint - acceptance • complications like migration of tube, rupture of central thinner segment, slitting of punctum – not found.

  19. Postoperative results

  20. 98% success • Success – resolution of symptoms like epiphora and discharge & a patent lacrimal system on irrigation. • Silicon intubation facilitates epithelialization of DCR fistula. Intubation tube in left eye

  21. Success rates with silicon intubation

  22. Conclusion • Meticulous surgery and proper identification of structures. • Big osteotomy esp, younger patients. • Silicon tube intubation in all. • Tight opposition of anterior flaps.

  23. Thank You

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