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Comparative Evaluation of the Ostium After External and Nonendoscopic Endonasal Dacryocystorhinostomy Using Image Processing (Matlabs and Image J) Softwares

Ganguly, Anasua M.D., D.N.B., F.I.C.O.*; Kaza, Hrishikesh D.N.B.*; Kapoor, Aditya D.O.*; Sheth, Jenil D.N.B.*; Ali, Mohammad Hasnat M.B.A.; Tripathy, Devjyoti M.S.*; Rath, Suryasnata M.S., F.R.C.S.*

Ophthalmic Plastic and Reconstructive Surgery: September/October 2017 - Volume 33 - Issue 5 - p 345–349
doi: 10.1097/IOP.0000000000000786
Original Investigations

Purpose: The purpose of this study was to compare the characteristics of the ostium after external dacryocystorhinostomy and nonendoscopic endonasal dacryocystorhinostomy (NEN-DCR).

Methods: This cross-sectional study included patients who underwent a successful external dacryocystorhinostomy or NEN-DCR and had ≥1 month follow up. Pictures of the ostium were captured with a nasal endoscope (4 mm, 30°) after inserting a lacrimal probe premarked at 2 mm. Image analyses were performed using Image J and Contour softwares.

Results: Of the 113 patients included, external dacryocystorhinostomy group had 53 patients and NEN-DCR group had 60 patients. The mean age of patients in the NEN-DCR group (38 years) was significantly (p < 0.05) lower than the external dacryocystorhinostomy group (50 years). There was no statistically significant difference (2 sample t test, p > 0.05) in mean follow up (6 vs. 4 months), maximum diameter of ostium (8 vs. 7 mm), perpendicular drawn to it (4 vs. 4 mm), area of ostium (43 vs. 36 mm2), and the minimum distance between common internal punctum and edge of the ostium (1 vs. 1 mm) between the external and NEN-DCR groups.

Conclusions: Image processing softwares offer simple and objective method to measure the ostium. While ostia are comparable in size, their relative position differs with posteriorly placed ostia in external compared with inferior in NEN-DCR.

Image processing software-based comparison found size of healed ostia to be comparable but the relative position on the lateral nasal wall was posterior in external versus inferior in nonendoscopic endonasal dacryocystorhinostomy.

*Ophthalmic Plastic and Reconstructive Surgery Service, L. V. Prasad Eye Institute, Bhubaneswar, India; and Departments of Clinical Epidemiology and Biostatistics, L. V. Prasad Eye Institute, Hyderabad, India

Accepted for publication August 3, 2016.

Financial supported by Hyderabad Eye Research Foundation.

Presented at Joint Meeting of the Asia Pacific Society of Ophthalmic Plastic and Reconstructive Surgery (APSOPRS) and Oculoplastics Association of India (OPAI) on September 27, 2014.

The authors have no conflicts of interest to disclose.

Address correspondence and reprint requests to Suryasnata Rath, M.S., F.R.C.S., Ophthalmic Plastics, Orbit and Ocular Oncology, L. V. Prasad Eye Institute, Bhubaneswar, India. E-mail:

© 2017 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.