A glued technique of external dacryocystorhinostomy

Abstract

Purpose: Fibrin glue was used for anastomosis of lacrimal sac and nasal mucosal flaps and was compared with the conventional suture technique in external dacryocystorhinostomy. Methods: A prospective interventional randomized control study in which 50 consecutive patients of primary acquired nasolacrimal duct obstruction (PANDO) were equally allocated into two groups. The case group underwent glued technique of external dacryocystorhinostomy (Ext DCR) in which fibrin glue was used for the apposition of the anterior lacrimal sac and nasal mucosal flaps. In the control group, conventional technique of Ext DCR was used to suture the flaps. Functional success was assessed by improvement in epiphora and fluorescein dye disappearance test (FDDT), whereas anatomical success was assessed by lacrimal irrigation and endoscopic view of the osteotomy site. Results: The anatomical success in both the groups was 92%, whereas the functional success was 92% in the case group and 88% in the control group. The difference in the success rates between the two groups was statistically non-significant. Conclusion: Glued technique of Ext DCR is a simple and easy alternative to suturing of the flaps. Though the final outcome was comparable in both the groups, glue can be especially useful in uncooperative cases, in cases of excessive bleeding, or in situations where the flaps are very thin or have become friable.

Endoscopic dacryocystorhinostomy with bicanalicular silicone tube intubation for treating chronic dacryocystitis secondary to nasolacrimal duct stent incarceration

“…N asolacrimal duct obstruction (NLDO) and chronic dacryocystitis have been reported as the most common ophthalmic disease of lacrimal duct obstruction [1][2] . Although dacryocystorhinostomy (DCR) surgery, e.g., external method dacryocystorhinostomy (Ex-DCR) and endoscopic transnasal method dacryocystorhinostomy (En-DCR), is a golden surgical method for treating this obstruction, nasolacrimal duct stents (NDS) have been used for treating NLDO and chronic dacryocystitis, with advantages of being amenable to performance on an outpatient basis, with high safety, with costeffectiveness, and being minimally invasive [3][4][5][6] . The efficacy of NDS is not encouraging.…”

The marvel of instant mucosal lining in dacryocystorhinostomy

“…Use of fibrin glue is a welcome but spillage and spread to the internal punctum and ostium is of concern as the authors have also expressed. [ 6 ] Hence the amount of glue to be used and the nuances associated especially when there is bleeding as glue application becomes difficult would have to be explained in finer detail. The mean age group in this study is around 40 years and majority are women who are concerned about the scar externally – these would have been a better group for endoscopic surgery.…”