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Effect of Timing of External Dacryocystorhinostomy on Surgical Outcome

Seider, Nir M.D.*; Kaplan, Nir M.D.; Gilboa, Michael M.D.*; Gdal-On, Mordechai M.D.*‡; Miller, Benjamin M.D.*‡; Beiran, Itzchak M.D.*‡

Ophthalmic Plastic & Reconstructive Surgery: May-June 2007 - Volume 23 - Issue 3 - p 183-186
doi: 10.1097/IOP.0b013e31804bdf0c

Purpose: To present our experience with external dacryocystorhinostomy (DCR) outcome and to compare cases of early and late DCR.

Methods: Retrospective data review of all patients who had external DCR with silicone intubation in a 7-year period. Data were collected and analyzed concerning patients’ preoperative and postoperative symptoms, and the lacrimal drainage system examination before, during, and after surgery.

Results: In all, 162 patients underwent 195 DCR surgeries for nasolacrimal duct obstruction. Success was achieved in 81% of surgeries. Success rates were higher in patients who had early DCR (tearing only or early inflammatory signs of the lacrimal sac, 84% success) than in cases that had late DCR (more than 6 months after inflammation started, 77% success). These differences were statistically insignificant. Failure of DCR was much higher in posttraumatic DCR than in DCR for other etiologies. Complications (in 9% of surgeries) were generally mild and infrequent, except 1 case of meningitis.

Conclusions: In experienced hands, external DCR has good postoperative success with a low complication rate. Early DCR does not have a substantial advantage over late surgery with regard to surgical outcome.

Early dacryocystorhinostomy does not substantially improve surgical outcome compared with late surgery.

*The Alberto Moscona Department of Ophthalmology, Rambam Medical Center, Haifa, Israel; †Clalit Heathcare Services, Primary Care Practice, Zur Shalom, Israel; ‡The Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.

Accepted for publication November 8, 2006.

The authors have no commercial or proprietary interest of any kind in the materials or techniques reported in this manuscript.

Address correspondence and reprint requests to Nir Seider, MD, Department of Ophthalmology, Rambam Medical Center, P.O. Box 9602 Haifa 32091, Israel; Email:

©2007The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc.