Revision Endoscopic Dacryocystorhinostomy with Betamethasone Injection under Assisted Local Anaesthetic

Purpose: To determine the success rate of revision endoscopic dacryocystorhinostomy (DCR) with an injection of intraoperative betamethasone under local anaesthetic. Methods: In a prospective, nonrandomized consecutive case series, 16 adult patients (19 eyes) with failed primary endoscopic DCR underwent revision surgery under assisted local anaesthetic. During revision endoscopic DCR, 1mg of betamethasone was injected into the lacrimal sac and scar tissue surrounding the surgical osteum. The surgical success rate was then determined based on anatomical patency and resolution of patient symptoms. Results: There were 16 patients (12 female, 4 male) and 3 had bilateral surgery. Patient ages ranged from 43 to 92 (mean 67). Follow up ranged from 1 to 15 months (mean 9). Anatomical patency was achieved in 16 cases (84%) and patient symptoms had improved in 17 cases (89%). Of the two cases that continued to have symptoms 1 achieved anatomical patency and the other had not. Conclusions: Revision endoscopic DCR, under assisted local anaesthetic, had a high success rate (89%) when an injection of betamethasone was administered intraoperatively.