* BACKGROUND AND OBJECTIVE: To evaluate the long-term success following external dacryocystorhinostomy, which is used as a standard in comparing endoscopic or laser techniques. * PATIENTS AND METHODS: A chart review of 128 patients (150 procedures) undergoing external dacryocystorhinostomy within a 14-year period was undertaken. Patient demographics, symptoms, examination findings, surgical and anesthesia information, postoperative course, and complications were recorded. Lack of tearing or evidence of dacryocystitis at the final postoperative visit was considered a successful result. * RESULTS: External dacryocystorhinostomy was found to be highly successful, with an overall 93% success rate at an average follow-up of 2.7 years. Kaplan-Meier analysis of the data, applied for the first time in this study, predicts a success rate of 90% beyond 4 years. Most important, this demonstrated that most surgical failures were identified in the first 2 years. Postoperative complications were rare and the surgical scar was not a source of patient concern in most cases. * CONCLUSIONS: This study confirms that external dacryocystorhinostomy is a highly successful longterm solution to nasolacrimal duct obstruction with low morbidity. [Ophthalmic Surg Lasers Imaging 2005;36:446450.]

Müller's muscle-conjunctiva resection ptosis repair using fibrin sealant for wound closure offers equivalent lid position and symmetry as compared with suture wound closure. There is also a reduction in major postoperative complications when using fibrin sealant.