Cutaneous scar visibility after external dacryocystorhinostomy: A comparison of curvilinear and W shaped incision

Abstract

Purpose The major drawback of an external dacryocystorhinostomy (ExDCR) is visible skin scar leading to poor patient satisfaction. In this study we have analyzed the skin scarring objectively after Curvilinear incision (CLI) and W shaped incision (WSI). Methods This is prospective trial done at Department of Ophthalmology at tertiary level hospital. All the patients with primary acquired nasolacrimal duct obstruction were included in the study. Patients were assigned to group A(CLI) or Group B (WSI). Cosmetic outcome was assessed by scar visibility at 1st, 3rd and 6th month postoperatively by two ophthalmologists separately, who were unaware of incision type. Results We studied 64 patients with median age 59.0 years (IQR [Interquartile range]: 50.0–66.8 years). Scar visibility was significantly (p = 0.001) more in WSI group at all follow-ups. None of the patients of CLI group showed visible scar at six months whereas ten patients (31.3%) of WSI group still had minimal scar (p < 0.001). Older patients had significantly less scar than younger patients. The time taken to perform ExDCR was significantly more with WSI (41.0 min, IQR: 40.0–44.0 min) than for CLI (33.0 min., IQR: 31.3–35.0 min); p < 0.05. Overall complication rates were similar in both the groups (p > 0.05) but extension of skin incision was more common in WSI group. Conclusions We found that CLI is more aesthetic, simpler, requiring less operative time and less incision related complications when compared with WSI.

Lacrimal Plasty with Dacryocystorhinostomy-Anastomosis Using Microsurgery

“…In addition, there have been some reports on the use of W-shaped incisions for facial scars, which is considered to be a disadvantage of the extranasal approach. 28 However, if the incision is made just above the lacrimal canal along the relaxed skin tension line and the wound edges are protected, the wound will not be noticeable in a normal plastic surgery closed wound.…”

Endoscopic dacryocystorhinostomy (EDCR) – A single group experience in an evolving technique and a review of literature

“…The cosmetic outcome is important and there is interest in changing the external incision to minimize the disfigurement maintaining the success rate. (Wadwekar et al, 2019) 9. Complication rate: Apart from two cases where there was postoperative epistaxis at the time of pack removal, no major complications were noted.…”

Dacriocistorrinostomía externa, conjuntivo-dacriocistorrinostomía y cirugía de la vía lagrimal en el meato inferior

“…Incisión. Desde la clásica incisión vertical en la pared lateral nasal descrita por Dupuy-Dutemps [3] se han descrito múltiples tipos de incisiones con la finalidad de conseguir el mejor resultado estético posible, entre ellas se encuentran la curvilínea en el pliegue naso palpebral [8] , subciliar en el párpado inferior [9] en W en la región nasal [10] y transconjuntival subcaruncular [9,10]. La incisión en el pliegue naso palpebral fue descrita por Harris SUMMARY: Introduction and objective: To carry out an update review on external dacryocystorhinostomy(ext-DCR), conjunctivo dacryocystorhinostomy (C-DCR) and inferior nasal meatus lacrimal surgery (lacrimal probing) to treat lacrimal system obstructions.…”