Comparison of Conventional Dacryocystorhinostomy versus Pawar Implant Dacryocystorhinostomy for the Management of Chronic Dacryocystitis

Introduction: Dacryocystorhinostomy (DCR) aims to bypass the nasolacrimal duct by creating an anastomosis between the lacrimal sac and the nasal mucosa. Conventional DCR is associated with several ostium-related complications and disadvantages such as longer operating time, larger ostium size, and the need for nasal packing. The Pawar intracystic implant was introduced to maintain the long-term patency of the ostium and promote healing of the flaps and ostium. Objectives: This study aims to compare conventional DCR with Pawar implant DCR for the management of dacryocystitis, in order to generate evidence for more effective treatment of this condition. Methods: This prospective, longitudinal, comparative study included 80 patients with chronic dacryocystitis. Patients were divided into two groups: Group A underwent conventional external DCR, and Group B underwent DCR with the Pawar implant. Patients were followed up with syringing on postoperative day 1 and at 1 week, 1 month, 3 months, and 6 months. Results: The mean age in Group A was 45.6 ± 8.4 years, and in Group B, it was 46.9 ± 9.8 years. The mean operating time in Group A was 50.1 ± 5.43 min, while in Group B, it was 25.5 ± 3.87 min, with a statistically significant difference ( P = 0.03). At the end of 6 months, the success rate was 87.5% in Group A and 95% in Group B, with a significant difference between the two groups ( P = 0.02). Conclusion: Implant DCR is safe and less time-consuming and requires a very small ostium, with no need for mucosal flap creation. Given its high success rate, the Pawar implant DCR procedure is a good alternative to conventional DCR surgery.