Outcome of external dacryocystorhinostomy in Ethiopian patients

An imbalance between tear production and drainage results in epiphora, which is an annoying symptom embarrassing the patient socially and functionally. The two widely accepted modalities of treatment for nasolacrimal duct obstruction (NLDO) are external dacryocystorhinostomy (EDCR) and endoscopic dacryocystorhinostomy. EDCR is the mainstay of treatment of NLDO and it remains to be the gold standard with which all other methods must be compared.

To determine the outcome of EDCR in Menelik II hospital, Addis Ababa, Ethiopia. The study was also intended to give a baseline data at a tertiary eye care center.

A prospective study was done in Menelik II Hospital. All patients scheduled for EDCR between June 2005 and May 2006 were included in the study. EDCR was done for all our cases. Success was defined by patient satisfaction (no complaint of tearing) supported by examination for regurgitation of fluid on pressing the lacrimal sac; and slit lamp assessment for increased tear meniscus.

One hundred and twenty eight eyes of 106 patients were included in the study, 36 (34%) were males and 70 (66%) were females. The male to female ratio was approximately 1:2. The commonest indication for dacryocystorhinostomy was chronic dacryocystitis 93 (72.7%). Patients were followed postoperatively for a mean follow up period of 9.3 months (6-12 months). Success was recorded in 119 (93%) of operated eyes. Patients graded incision scar as excellent in 107 (83.6%) eyes, good in 9 (14.8%) and bad in 2 (1.6%) eyes. All patients respond that they would recommend operation for others.

The success rate of EDCR in our set up is comparable to studies done in other parts of the world and EDCR is a very effective surgical procedure for our patients with NLDO.