Minimum incision no skin suture external dacryocystorhinostomy

Area of Science:

• Ophthalmology
• Oculoplastics
• Surgical Innovation

Background:

• Nasolacrimal duct obstruction (NLDO) significantly impacts quality of life.
• Traditional external dacryocystorhinostomy (Ext-DCR) can result in noticeable scarring.
• Minimally invasive surgical approaches are increasingly sought after in oculoplastics.

Purpose of the Study:

• To detail the technique of a 5-mm incision, no-skin-suture external dacryocystorhinostomy (Ext-DCR).
• To evaluate the functional and anatomical success rates of this minimally invasive Ext-DCR procedure.
• To assess patient satisfaction regarding the cosmetic outcome of the small incision.

Main Methods:

• Retrospective interventional case series of 77 patients (85 procedures) with NLDO.
• A standardized 5-mm skin incision was utilized for all external dacryocystorhinostomy (Ext-DCR) procedures.
• Silicone tube intubation was performed, with removal planned at 6 weeks; success defined by symptom resolution, free irrigation, and patient satisfaction scores.

Main Results:

• High anatomical (98.8%) and functional (95.3%) success rates were achieved in 85 procedures.
• Mean follow-up was 12.9 months; mean patient satisfaction score for incision appearance was 99.2.
• Canalicular stenosis was associated with significantly lower success rates (p=0.00), though wound elongation was minimal and did not require sutures.

Conclusions:

• The 5-mm incision, no-skin-suture external dacryocystorhinostomy (Ext-DCR) is a safe and effective procedure.
• This technique offers high success rates and excellent patient satisfaction, particularly regarding cosmetic results.
• It represents a valuable minimally invasive option for managing nasolacrimal duct obstruction (NLDO).