Long-Term Outcomes of External Dacryocysto­rhinostomy with U-Flap and Nasolacrimal Intubation in Adult Patients with Small Lacrimal Sac and Primary Nasolacrimal Duct Obstruction

Overview

Aim: To report long-term postoperative outcomes of external dacryocystorhinostomy (Ext-DCR) with U-flap and nasolacrimal intubation in adult patients with small lacrimal sac and primary nasolacrimal duct obstruction (NLDO).

Material and methods: This case series was conducted in a tertiary health care center of North India and included 26 patients who underwent Ext-DCR with U-flap with nasolacrimal intubation for primary NLDO and small lacrimal sac from June 2021 to January 2024 with a minimum follow-up period of 12 months.

Results: Out of 26 patients, 22 were females with a mean age of 50 years (range 21–60). All patients had a history of purulent discharge from the affected eye. Excessive bleeding was the most common intraoperative challenge faced in most of the cases (6, 23%). The intubation set was removed 12 weeks after surgery. Two female patients had tube-related complications in the form of granuloma formation, and two patients had tube retraction, one had slitting of the punctum, and another acquired an infection. The remaining 20 patients had an uneventful postoperative period. The outcomes of only 2 patients were reported as failures (8%), and the remaining 24 reported successful outcomes (92%) after 12 months of follow-up.

Conclusion: Ext-DCR with U-flap and nasolacrimal intubation is an effective procedure with a high long-term success rate in adult patients with a small lacrimal sac and primary NLDO.

Keywords:

external DCR – U-flap – nasolacrimal intubation – chronic dacryocystitis – small lacrimal sac