Surgical Outcomes of External Dacryocystorhinostomy Under Local Anaesthesia in a Tertiary Care Hospital: A Prospective Cohort Study

Abstract

Objective: This study was designed to conclude the success rate of external dacryocystorhinostomy surgery, patient concerns about surgical scar mark and their satisfaction with the appearance of surgical scar. Methods: A prospective cohort study was conducted at Department of Ophthalmology, Gujranwala Medical College/ Teaching Hospital. Total 74 operated cases of DCR surgery under local anaesthesia in two year period (2018-19) were included. Mean follow-up was up to 11 months. Surgical success was defined as resolution of complaint of epiphora. Surgical failure was defined as blockage of lacrimal pathway on syringing. Patient concerns about surgical scar mark and their satisfaction with the appearance of surgical scar was also assessed by telephonic interview. Results: Out of 74 patients 61 (82.43%) were female and 13 (17.56%) were male. Mean age of patients was 39.49 ± 14.26 years.10 patients had epiphora at the end of follow-up. Majority of failed cases presented at 3 month. Lacrimal syringing on 1 week follow-up was effective to clear any debris or blood clot. The success rate (86.49%) calculated from those patients (n = 67) who completed the follow-up. 46 (68.65%) were not satisfied with the appearance of their surgical scar mark. Conclusion: External DCR performed in local anesthesia is a safe procedure with a success rate of above 85% at one year follow-up. Lacrimal pathway syringing, on follow-up after DCR surgery, can be effective to wash blood clot or debris. Majority of the patient do not find surgical scar mark cosmetically acceptable.