Dacryocystorhinostomy (DCR) surgery failure is usually due to the closure of the surgical osteotomy. Creation of a large osteotomy helps to increase the chances of success of surgery.
Objective: To evaluate the size of osteotomy made during surgery and its correlation with successful DCR surgery.
Methodology: A retrospective review of 50 patients (19 males, 31 females) more than 10 years of age, over a period of 24 months were done. The External DCR surgery was performed by ophthalmic surgeon in patients of chronic dacryocystitis or after resolution of acute inflammation. All patients were operated by same technique of local anesthesia and nasal packing. Curvilinear skin incision 7-8 mm from medial canthus. Cutting of medial palpebral ligament. Identification of lacrimal sac and fossa. Creating large bony ostium by direct visualization. Measuring and recording of size of ostium using sterile measuring caliper. Suturing of anterior mucosal flaps. Retrospective data collection included the patient’s age, sex, affected side, symptoms, operative experience, and follow-up results.
Results: Complete Patency in 49 (98%) patients and Partial Patency in 01 (2%) patient. Overall success rate of Ext. DCR surgery is 92-94% with complete relief from epiphora achieved in 90% of cases.
Conclusion: The successful DCR surgery requires a Big Osteotomy size with a mean value of 1.2cm±0.3 SD which differs from patient to patient according to sac size and bone, along with meticulous surgery and proper identification of structures and tight apposition of anterior mucosal flaps.