A randomized study comparing DCR with and without excision of the posterior mucosal flap

AIM: A prospective randomized study was carried out to compare the success rate of external dacryocystorhinostomy (DCR) with and without excision of the posterior sac mucosal flap. METHODS: Forty patients (Group A) underwent DCR without excision of the posterior sac mucosal flap, and the results obtained were compared with those of another series of 40 patients (Group B) where DCR was performed with excision of the posterior sac flap. A large posterior flap was excised from the lacrimal sac and a large, mobile, anteriorly-hinged, nasal mucosal flap was fashioned. The latter was joined to the anterior sac flap using a 6/0 double-armed polyglycolic acid suture. RESULTS: Four patients in Group B had signs and symptoms of tearing (90% success rate) at the end of the follow-up period (mean 11.05 months, range 9-14 months). Group A had six patients with recurrent signs and symptoms (85% success rate) by the end of a mean follow-up period of 11.3 months (range 9-14 months). CONCLUSION: Excision of the posterior sac mucosa may improve the success rate of external DCR.