Minimum Incision No Skin Suture External Dacryocystorhinostomy

Purpose: To report the technique and results of 5-mm incision no skin suture external dacryocystorhinostomy procedure (Ext-DCR). Methods: In a retrospective interventional case series, 77 patients (85 procedures) with nasolacrimal duct obstruction (NLDO) were included. The size of skin incision was 5 mm. Silicone tube was inserted in all and planned to be removed 6 weeks after the operation. Functional success was defined as no symptom or just excess tear in the cold weather and anatomical success as free irrigation at last follow-up time (at least 6 months) when patients' satisfaction (visual analogue score) on the site of incision was also recorded. Results: There were 85 procedures in 77 patients (52 women; 67.5%) with primary acquired (82) or traumatic (3) NLDO and with a mean age of 52.9 years and follow up of 12.9 months. Associated common canalicular stenosis (membrane) was found in 15 (17.6%), canalicular stenosis in 2 (2.4%), and both in 2 (2.4%) cases. Anatomical and overall functional success was 98.8% (84/85) and 95.3% (81/85), respectively. Subjects with canalicular stenosis had a lower anatomical (75%) and functional (50%) success rates, which were statistically significant (p = 0.00). Wound elongation (up to 8 mm) was observed in 3 cases, which did not require skin suturing. Mean patient satisfaction score for the appearance of incision was 99.2. Conclusion: Minimum incision (5 mm) no skin suture Ext-DCR offers high patient satisfaction and success rates.