JSWMC

Introduction: The history of external dacryocystorhinostomy (DCR) operation is more than hundred years old. This procedure was upgraded several times by different ophthalmologists. Methods: The purpose of this study to evaluate the efficacy and outcome of the most recent modification of the DCR operation, where both anterior and posterior mucosal flaps were excised instead of anastomosis along with silicon tube intubation; So that making the procedure easy, quick and approachable with better outcome. This prospective study was conducted at the Friends Eye Hospital, Akhalia, Sylhet from January 2015 to December 2017. Results: A total of 120 patients with complaints of primary nasolacrimal duct obstruction included in this study; Out of them, 30 were male and 90 were female (1:3). Age ranged from 16 years to 75 years, mean age was 40.67±14.88 years. Epiphora was present in all patients which associated with mucopurulent discharge in 41.67%, mucoid discharge in 25%, mucocele in 10% and lacrimal fistula in 6.67% patient. Observed complications of operation includes primary hemorrhage (2.5%), DCR tube adhesion (1.66%), loss of DCR tube (0.83%) and epicanthic fold (0.83%); there was no occurrence of secondary hemorrhage and infection. After one-year of follow-up, epiphora was absent in 112 (93.34%) cases and the passage was found patent on sac patency test. Among the remaining 8 (6.66%) cases, two patients had epiphora only, three patients had epiphora with mucopurulent discharge, and three patients had epiphora due to complications of the operation.This modified and simple DCR procedure found to have higher success rate (93.34%) with minimal complication (5.83%). Further comparative study is needed for better result.