• Mir Zaman
  • Tariq Farooq Babar
  • Nasir Saeed


Background: The study was conducted at the DHQ hospital Lakki Marwat from Jan, 1999 to Dec, 2002 to assess the intra and postoperative complications and success rate of external dacryocystorhinostomy (DCR) with suturing of the bridge between anterior flaps of nasal mucosa and lacrimal sac with the muscle layer. Method: We operated upon 120 patients suffering from chronic dacryocystitis (CDC). Females were 81 (67. 5%) and males were 39 (32.5%). Majority of the patients were between the age group 40 to 60 years. Indications for dacryocystorhinostomy (DCR) were epiphora, acute on chronic dacryocystitis and a mucocele. All the cases were operated under local anaesthesia with external approach and only anterior flap suturing and engaging it in the muscle layer. These patients were followed for a period of six months. Results: The overall success rate was 98.33%. The successful outcome was defined as symptomatic relief from epiphora and dacryocystitis and a patent nasolacrimal duct upon syringing. Conclusions: Dacryocystorhinstomy is a safe procedure under local anaesthesia. It is associated with minimal complications, which can be easily managed. This technique has a very high success rate and a short learning curve.Keywords: External dacryocystorhinostomy, Chronic dacryocysttitis, Epiphora.


Toti A. Nuovo metodo conservative di cura radicalle delle supporazioni cronicle del sacco lacrimale Clin Mod Firenze 1904;10: 385-9.

Dupuy-Dutemps L, Bourguet J. Procede plastique de dacryocystorhinostomie et ses resultats. Ann Ocul J 1921; 158: 241-61.

Ohm J. Nerbesserungen an meinen Nystagmographen. Klin Monatsble Augenheilk 1926; 1: 791-4.

Ilifff CE. A simplified dacryocystorhinostomy. 1954- 1970. Arch ophthalmol 1971; 85: 586-91.

Older JJ. Routine use of a silicone stent in a dacryocystorhinostomy. Ophthalmic Surgery 1982; 13: 911-5.

Seppa H, Grenman R, Hartikainen J. Endonasal Co2-Nd: YAG laser dacryocystorhinostomy. Acta-ophthalmol Copenh. 1994; 72 (6): 703-6.

Baig MSA, Shaikh Z.A, Aziz Misbahul. External dacryocystorhinostomy with silicone tube intubations. Pak J Ophthalmol 2000; 16 (2): 90-3.

Unlu HH, Toprak B, Aslan A, Guler C. Comparison of surgical outcomes in primary endoscopic dacryocystorhinostomy with and without intubation. Ann Otol Rhinol Laryngol 2002; 111 (8): 704-9.

Moore WM, Bentley CR, olver JM. Functional & anatomic results after two types of endoscopic endonasal dacryocystorhinostomy: surgical and holmium laser. Ophthalmology 2002; 109 (8): 1575- 82.

Yazici Z, Yazici B, Parlak M, Ertirk H, Savi G. Treatment of obstructive epiphora in adult by balloon dacryocystoplasty. Br J Ophthalmol 1999; 83 (6): 692-6.

Ali A, Ahmad T A. Dacryocystorhinostomy – a review of 51 cases. Pak J Ophthalmol 2001; 17 (4) : 122-8.

Talpur KI, Jatoi SM, Khan SA. Dacryocys-torhinostomy – a clinical report of 54 cases. Pak J Ophthalmol 1998; 14(4): 169 – 71.

Ahmad MA. Dacryocystorhinostomy with and without intubation. Pak J Ophthalmol 1992; 8(2): 39-42.

Jorge GC, Alfonso UB, Nasolacrimal duct obstruction. e Medicine 2001;7: 1-13.

Dareshani S, Niazi J.H, Saeed M, Memon MS, Mehmood T. Dacryocystorhinostomy: importance of anastomosis between anterior and posterior flaps. Pak J Ophthalmol 1996; 12(4): 129-31.

Hurwitz JJ, Merkur Si, De Angelis D. Outcome of lacrimal surgery in older patients. Can J Ophthalmol 2000; 35(1): 18-22.

Khan MD, Kundi NK. A review of 200 cases with blocked tear duct. Khyber Med Col J 1983; 4: 15-7.

Welham RAN, Wulc AE. Management of unsuccessful lacrimal surgery. Br J Ophthalmol 1987; 71: 152-7.

Ashraf M. A study of dacryocystorhinostomy using consecutive laminar bone resection for performing osteotomy. Pak J Ophthalmol 1996; 12: 61-6.

Mc Lachlan DL, Shannon GM, Flanagan JC. Results of dacryocystorhinostomy: analysis of re-operations. Ophthalmic Surg 1980; 11: 427-30.

Jordan DR, McDonald H. Failed dacryocystorhinostomy: the sump syndrome. Ophthalmic Surgery 1993; 24: 692-3.