Scarless Transconjunctival dacryocystorhinostomy with anterior flaps in management of acquired nasolacrimal duct obstruction

Abstract: Purpose: assessment of the success’s rate in management of acquired nasolacrimal duct obstruction (ANLDO) without skin incision through the conjunctiva with anterior flap formation. Methods and Materials: prospective non randomized study of 41 eyes of 35 patients complaining of acquired nasolacrimal duct obstruction; in period of March 2013 to March 2014; diagnosed preoperative by; dye disappearance test (DDT) and irrigation of nasolacrimal duct. Excluded patients with punctual stenosis, canalicular obstruction and recurrent nasolacrimal duct obstruction .Operative; all patients had lacrimal sac connected to the nose through inferomedial conjunctival wound in lower eye lid without skin scar formation. Postoperative; follow up after one day, 1 weak ,3 months,6 months then removal of silicon tube and assisted by subjective improvement of the patient ,DDT and at 9 months assisted by DDT ,and irrigation of nasolacrimal duct . Statistical analysis used: Based on IBM SPSS Statistics (version 22, SPSS, Inc.). Results: In 35 eyes of patients (85.4%), after complete follow up, the operation had been done successfully with complete absence of epiphera, during following up 6 eyes of patients (14.6%) had granuloma formation on the conjunctiva wound produced more epiphora. 6 eyes of patients (14.6%) showed; recurrent of epiphora. they are treated by external dacryocystorhinostomy and the symptoms are improved. Discussion: the success rate of transconjunctival technique of dacrocystorhinostomy in management of ANLDO is considered high 85.4%, in comparable to external and endoscopic DCR but without facial scar and without laser or endoscope assessment.

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[Mahmoud Ahmed El-Samkary MD (2015); Scarless Transconjunctival dacryocystorhinostomy with anterior flaps in management of acquired nasolacrimal duct obstruction Int. J. of Adv. Res. 3 (4). 0] (ISSN 2320-5407). www.journalijar.com

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