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Flapless external dcr: Is it time to say good bye flaps?

Ravi ranjan, Kumari rupam and Sudhir kumar

Acquired duct (ANLD) obstruction may be a common ophthalmic problem with bothersome complications. The mainstay treatment of ANLD obstruction is DCR, either external or end nasal. As end nasal DCR is carried without flap making and has high success rate, the aim of this study is to evaluate the success of external DCR with neither anterior nor posterior flaps. Patients and Methods: Prospective clinical study was performed on 28 eyes (26 patients, 2 bilateral and 24 unilateral) with epiphora thanks to ANLD obstruction with no past history of lacrimal surgery. All patients were managed with external DCR with neither anterior nor posterior flaps. Results: 26/28 eyes treated with this procedure showed complete resolution of epiphora successfully rate of 92.8%. Conclusion: I suggest that DCR with no flap making is effective and straightforward procedure within the management of ANLD obstruction and flap making isn’t an important step in the procedure as it has no impact on the final outcome. This study included 106 patients with lacrimal system disorders who underwent the external dacryocystorhinostomy. Fifty four patients (Group A) underwent external dacryocystorhinostomy with suturing anterior and posterior flaps of the tear sac and nasal mucosa, and therefore the results obtained were compared with those of another series of 52 patients (Group B) where dacryocystorhinostomy was performed with suturing only the anterior flaps, whereas posterior mucosal flaps were excised.