Abstract
Purpose: To document the results of External dacryocystorhinostomy (EX-DCR)under Local Anesthesia with sedation for treatment of nasolacrimal duct (NLD)obstruction.Study Design: Interventional study case series.Place and duration of Study: conducted at a private clinic in Gilgit Pakistanover a 3 year period.Materials and Methods: Data was prospectively collected on all patients whounderwent EX-DCR. The Indication for surgery was a blocked nasolacrimal ductobstruction. Patients underwent irrigation of the nasolacrimal drainage systems,fluorescein dye disappearance test, and intranasal examination. Patients withprevious dacryocystorhinostomy surgery to the same eye were excluded fromthe study. EX-DCR was performed under local anesthesia with sedation onoutpatient basis by a single surgeon having expertise in the technique. Follow upwas at day 1, 1st week and on 6th month for. During postoperative visits,patients were asked about symptomatic resolution of epiphora and assessedwith patency on irrigation, fluorescein dye disappearance test, and intranasalexamination. All patients were followed up for at least 6 months. Surgicalsuccess was defined by patient’s resolution of symptoms with patency onirrigation.Results: 61 patients were included in the study with a mean age of 37.16 ± 12years. Most of the operated patients were females (77.05%) with a nearly equaldistribution between left and right eyes. Intraoperative complications were unableto suture posterior flap (4.92%), excessive bleeding above 100ml in one patient,snipping of puntum one patient and unable to pass DCR tube in one patient.None of the patients had uncontrolled intranasal bleeding, cardiovascular eventor local anesthesia toxicity during the surgery. All of the patients had asuccessful outcome which was determined by patent syringing. The mostcommon Post-operative complication was ecchymosis in 14.75%.Conclusion: In order to avoid the risks of General anesthesia, EX-DCR underLA with sedation is a safe and highly effective alternative technique in terms ofsurgical outcome.Key Words: Dacryocystorhinostomy, local anesthesia, nasolacrimal ductobstruction.
Qaim Ali Khan, Sohail Zia, Yasir Iqbal. (2016) External Dacryocystorhinostomy Under Local Anesthetia, Pakistan Journal of Ophthalmology, Volume 32, Issue 1.
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