Meandros Medical And Dental Journal

Öz

Objective: To compare the surgical success rate between viscoelastic-facilitated external dacryocystorhinostomy (DCR) surgery and conventional external DCR surgery in patients with acquired nasolacrimal duct obstruction.
Materials and Methods: In this retrospective, comparative cohort study, data of patients who underwent external DCR surgery and silicone tube intubation between 2017 and 2023 were evaluated. Among the 99 cases with no prior surgical history, 46 cases were allocated to the viscoelastic group (viscoelastic substance was used to fill the lacrimal sac just before creating the mucosal flaps), while 53 cases were allocated to the conventional group. All surgeries were performed by the same surgeon. Surgical success was defined as the presence of an open lacrimal drainage system confirmed by a lacrimal irrigation test and/or relief of epiphora.
Results: There were no significant differences observed between the groups with regards to age, gender, DCR tube extubation time, and side of the surgery (right/left lacrimal sac) (p>0.05). The mean follow-up was 27.8±20.9 (6-66) months in the viscoelastic group and 22.9±20.2 (6-64) months in the conventional group (p=0.35). Two cases in the viscoelastic group and four cases in the conventional group experienced recurrence during the follow-up period. Surgical success rates were calculated as 95.7% and 92.5% for the viscoelastic group and the conventional group, respectively (p=0.68).
Conclusion: Viscoelastic-assisted external DCR surgery is as successful as conventional external DCR surgery. We are particularly of the opinion that this approach would enhance surgical success, especially in cases where the lacrimal sac is small and fibrotic.