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Br J Ophthalmol 1998;82:790-792 ( July )

Anterior suspended flaps: a modified approach for external dacryocystorhinostomy

Lelio Baldeschi,a b Marco Nardi,a Christoph R Hintschich,b c Leo Koornneefb

a Neurosciences Department of Pisa University, Section of Ophthalmology, Pisa, Italy, b Orbital Center, Department of Ophthalmology, University of Amsterdam, Amsterdam, Netherlands, c University Eye Hospital, Ludvig Maximilians University of Munich, Munich, Germany

Correspondence to: Dr Lelio Baldeschi, Room A2-119, Orbital Center, Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.

; Accepted for publication 29 January 1998

BACKGROUND/AIMS---External dacryocystorhinostomy (DCR) is a reliable but difficult surgical technique for the treatment of any obstruction of the lacrimal drainage system lying distal to the internal opening of the common canaliculus. In this prospective study, a simplified external DCR procedure and the results obtained on a series of 45 consecutive patients, in which traditional external DCR was indicated, are described.
METHODS---In this modified procedure only very large and mobile anterior flaps of the lacrimal sac and nasal mucosa are created. Thanks to the large size and the great motility the two flaps can be easily sutured. Two double armed 6/0 polyglycolic acid sutures are used to join the two flaps, to elevate them anteriorly in order to avoid adhesions with underlying tissues, and to approximate the deep planes of the wound. The mean operative time was measured.
RESULTS---At the end of follow up period (mean 17 months, range 14-24 months) all patients had no sign or symptoms of tearing and normal Jones I dye test. The mean operative time was 28.6 minutes (range 23-44 minutes)
CONCLUSION---We believe that our modified technique can be used to simplify and speed up traditional external DCR without decreasing its well known reliability.

Keywords: external dacryocystorhinostomy; anterior mucosal flaps

© 1998 by British Journal of Ophthalmology




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