TO COMPARE THE SUCCESS RATE OF EXTERNAL DACRYOCYSTORHINOSTOMY WITHOUT AND WITH POSTERIOR MUCOSAL FLAP SUTURING

Authors

  • Rizwan rasheed Department of Ophthalmology, Layton Rahmatullah Benevolent Trust hospital, Karachi-Pakistan
  • Zeeshan Kamil
  • Sahira wasim
  • Saliha naz
  • Tanweer hassan
  • Uzma naz

Keywords:

key words: External dacryocystorhinostomy, posterior mucosal flaps, suturing.

Abstract

Background: This study aims to compare the success rate of external dacryocystorhinostomy (Ex- DCR) without suturing of posterior mucosal flap and with both anterior and posterior mucosal flap suturing. Methods: This quasi-experimental study was conducted at a tertiary care hospital from January to December 2023 after ethical board approval. Patients were divided into two groups, A and B, with 50 patients in each. In group A Ex-DCR with suturing of anterior and excision of posterior mucosal flap were included. In group B Ex-DCR with both anterior and posterior mucosal flap suturing were included. Patients followed at one week, 1, 3 and 6 months. Success rate of the procedure was evaluated by symptomatic relief of patients epiphora and patent nasolacrimal passage on syringing after 6 months of DCR. Results: Out of 100, 68 were females and 32 males. Mean age was 47.7 and 46.4 years in Group A and B respectively. Watering at presentation was 35 and 32 in Group A and B respectively. Watering with mucous discharge was 15 and18 in Group A and B respectively. The success rate was found as 47 (94%) in group A and 48 (96%) in group B, insignificant statistical difference found between both groups. Conclusions: Our study showed comparable success rate of Ex-DCR between both suturing techniques in which anterior and posterior flap suturing group and with anterior flap suturing and excision of posterior flap group.

References

1. Roohé SL, Helsen S, Paridaens D. Medial lacrimal sac excision versus conventional H-shaped lacrimal sac opening in external dacryocystorhinostomy: a comparative cohort study. Orbit 2024;43(1):1–7.

2. Ossama N, Sheriff Elwan MD, Nancy N. Meta-Analysis of Flaps Management in External Dacryocystorhinostomy. Med J Cairo Univ 2022;90(9):1603–18.

3. Ceylanoglu KS, Acar A, Sen E. Overview of Epiphora Referred to Oculoplastic Surgery Clinic in Adults. Beyoglu Eye J 2023;8(1):45–9.

4. Mansour HO, Hassan RE, Tharwat E, Elgazzar AF, Abd El-Salam ME, Ezzeldin ER, et al. Comparing the success rate of external dacryocystorhinostomy with anterior flap versus flap excision in managing chronic dacryocystitis. Med Hypothesis Discov Innov Ophthalmol 2023;12(1):1–8.

5. Borkar S, Umate R. Case Report on Right Chronic Dacryocystitis with Lacrimal Sac Abscess. J Pharm Negat Results 2022;13(3):1032–4.

6. Verma S, Midya U, Gupta S. The success rate of external dacryocystorhinostomy with and without suturing the posterior mucosal flaps. J Ophthalmol 2021;6:23–6.

7. Engelsberg K, Sadlon M. First-onset dacryocystitis: characterization, treatment, and prognosis. Ophthalmol Ther 2022;11(5):1735–41.

8. Wang Y, Liu F, Cao M, Xie L, Tan S, Liu L. Efficacy and Safety of Modified Seamless Endoscopic Dacryocystorhinostomy in Patients with Chronic Dacryocystitis. J Ophthalmol 2022;2022:3061859.

9. El Bouhmadi K, Loudghiri M, Oukessou Y, Rouadi S, Abada R, Roubal M, et al. Evaluation of the endoscopic revision of dacryocystorhinostomy failure cases: a cohort study. Ann Med Surg 2023;85(9):4218–22.

10. Kacaniku G, Begolli I. External dacryocystorhinostomy with and without suturing the posterior mucosal flaps. Med Arch 2014;68(1):54–6.

11. Shaikh NA, Mahesar ML, Jandan NA, Shaikh FA, Shaikh AA. Comparing the success rate of dacryocystorhinostomy with and without posterior mucosal flap in fistulous dacryocystitis. Rawal Med J 2022;47(3):633–6.

12. Khan FA, Yaqub MA, Fayyaz M. The importance of excising or suturing the posterior mucosal flaps in external dacryocystorhinostomy. Pak J Ophthalmol 2010;26(2):69–73.

13. Deka A, Saikia SP, Bhuyan SK. Combined posterior flap and anterior suspended flap dacryocystorhinostomy: A modification of external dacryocystorhinostomy. Oman J Ophthalmol 2010;3(1):18–20.

14. Cubuk M, Bardak H, Çetinkaya S, Güvenmez O. Results of Single and Double Flap Anastomosis in External Dacryocystorhinostomy Surgery. Ulutas Med J 2019;5(2):160–5.

15. Takahashi Y, Mito H, Kakizaki H. External dacryocystorhinostomy with or without double mucosal flap anastomosis: comparison of surgical outcomes. J Craniofac Surg 2015;26(4):1290–3.

16. Katuwal S, Aujla JS, Limbu B, Saiju R, Ruit S. External dacryocystorhinostomy: do we really need to repair the posterior flap? Orbit 2013;32(2):102–6.

17. Pandya VB, Lee S, Benger R, Danks JJ, Kourt G, Martin PA, et al. The role of mucosal flaps in external dacryocystorhinostomy. Orbit 2010;29(6):324–7.

18. Serin D, Alagöz G, Karsloglu S, Çelebi S, Kükner S. External dacryocystorhinostomy: Double-flap anastomosis or excision of the posterior flaps? Ophthalmic Plast Reconstr Surg 2007;23(1):28–31.

19. Elwan S. A randomized study comparing DCR with and without excision of the posterior mucosal flap. Orbit 2003;22(1):7–13.

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Published

2026-08-18

How to Cite

1.
Rizwan rasheed, Zeeshan Kamil, Sahira wasim, Saliha naz, Tanweer hassan, Uzma naz. TO COMPARE THE SUCCESS RATE OF EXTERNAL DACRYOCYSTORHINOSTOMY WITHOUT AND WITH POSTERIOR MUCOSAL FLAP SUTURING. J Ayub Med Coll Abbottabad [Internet]. 2026 Aug. 18 [cited 2026 Sep. 9];38(1):50-3. Available from: https://www.jamc.ayubmed.edu.pk/index.php/jamc/article/view/13156