External Dr Research Paper

External DCR – a highly successful procedure with a low learning curve

Dr. Karan Bhatia DOMS, DNB;1,2,3 Dr. Sabyasachi Sengupta DO, DNB, FRCS;2,

Col. Dr. Madhu Bhadauria MS1

Author Affiliations:

1. Regional Institute of Ophthalmology, Sitapur Eye Hospital, Sitapur

2. Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry

3. M. M. Joshi Eye Institute, Gokul Road, Hosur, Hubli

Corresponding author –

Dr. Karan Bhatia DOMS, DNB

Email – [e-mail] Abstract

Aim – To determine the success rate in patients undergoing External Dacryocystorhinostomy (DCR) with acquired naso-lacrimal duct obstruction (NLDO), when done by a learning ophthalmologist.

Materials and Methods – A prospective study of adult patients

Introduction

External Dacryocystorhinostomy (DCR) remains the gold standard surgery for the treatment of Acquired Nasolacrimal obstruction (NLDO), since Totti described the first DCR operation in 1904.[1] It is being practiced all around the world for Acquired Nasolacrimal Duct Obstruction. With the development of Endonasal DCR, it is losing its popularity. However, it still has a very high success rate even when done by learning ophthalmologists.

Aim

To determine the success rate in patients undergoing External Dacryocystorhinostomy (DCR) with acquired naso-lacrimal duct obstruction (NLDO), when done by learning ophthalmologists.

Materials and Methods A prospective study of adult patients undergoing external DCR was done for acquired complete NLDO. Post-operative success rate was determined by lacrimal sac syringing and subjective resolution of epiphora.

Inclusion Criteria

 Patients suffering with complaints of epiphora, diagnosed as Acquired NLDO confirmed by lacrimal sac syringing.

Exclusion Criteria

 Age < 18 years, > 70 years

 Canalicular block (diagnosed by lacrimal sac

2. A questionnaire to evaluate the postoperative improvement of their epiphora. The patients were asked to quantify their symptoms as follows –

A. No improvement, discharge and epiphora still persistent

B. No improvement, epiphora is the same or worse

C. Slight improvement, but epiphora still present

D. Significant improvement, but slight epiphora

E. Complete resolution of epiphora

Patients reporting as A, B, C were defined as “failures” and D, E as “successes”.

Observation and Result

114 Eyes were operated during the period from November 2011 to December 2013 at Sitapur Eye Hospital by a learning ophthalmologist. Average age was 35.68 years. RE was affected in 70 patients (61.40%) and LE in 44 patients (38.60%) (Table 1). Males were 24 (21.05%) and females 90 (78.95%). Male: female ratio was 1:3.75 (Table 2).

Table 1: Laterality

Eye Number

Right 70 (61.40%)

Left 44 (38.60%)

Table 2: Patient Demography – Gender

Gender Number

Male 24 (21.05%)

Female 90