Inferior Flap Anastomosis in External Dacryocystorhinostomy

In Brief Purpose: To describe the inferior flap design as a modification in external dacryocystorhinostomy (DCR) and to evaluate the effectiveness on surgical outcome. Methods: This prospective study enrolled 33 consecutive patients with acquired nasolacrimal duct obstruction who underwent external DCR with this modified flap design from February 2007 to April 2008. Success was defined as amelioration of epiphora and anatomic patency. Operative outcomes and success of the procedure were evaluated. Results: The mean age was 45 years (range, 12–65 years). The mean follow-up time was 15.6 months (range, 10–23 months). None of the patients had signs or symptoms of epiphora at the end of the follow-up period. Conclusions: The inferior flap design simplifies the surgical procedure and produces success rates comparable with those found in conventional DCR. Further studies with larger numbers of patients are necessary. Inferiorly based flap anastomosis in external dacryocystorhinostomy is an alternative approach that simplifies the surgical procedure and produces success rates comparable with those found in conventional DCR.