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Purpose: To evaluate the cosmetic and functional outcomes of subciliary incision for external dacryocystorhinostomy (DCR). Methods: This study was a prospective interventional case series. Thirty eyes of external DCR for primary acquired nasolacrimal duct obstruction were done through the subciliary skin approach. Successful functional outcome was defined as relief from epiphora, and normal Fluorescein Disappearance Test (FDT). The cosmetic outcome of the scar was evaluated objectively by the surgeon and subjectively by the patients using the scar grading scale of the postoperative photographs: 0- invisible incision; 1- minimally visible incision; 2- moderately visible incision; and 3- very visible incision. The follow up visits were done over a period of 6 months after surgery. Results: The study included thirty eyes of 26 patients. Primary external DCR through subciliary approach was done for all cases over a period of 3 years starting from June 2013 to May 2016. Four patients (5.5%) of these 26 patients had bilateral DCR. Epiphora was markedly improved in all cases with average reduction of Fluorescein Disappearance Test (FDT) from 17.8 minutes to 3.1 minutes. Objective grading of the scars was 100% invisible (grade 0) and Subjective scar grading by the patients was 100% invisible (grade 0) at the end of the postoperative follow up visits without any other complications related to surgery. Conclusions: The subciliary incision for external DCR has a high functional success outcome with the advantage of an excellent cosmetic and satisfying scar outcome to the surgeon and the patient. The subciliary approach was simply an attempt to combine the best of 2 worlds, namely subciliary incision and external DCR. Recent Publications 1. Devoto M H, Zaffaroni M C, Bernardini F P et. al. (2004) Postoperative evaluation of skin incision in external dacryocystorhinostomy. Ophthal Plast Reconstr Surg. 20(5):358-361. 2. Tarbet V D et. al. (2012) Subciliary incision for external dacryocystorhinostomy. Ophthal. Plast. Reconstr. Surg. 28(5):341-345.
Hossam E Elbarbary graduated from Faculty of Medicine, Alexandria University, Egypt in 2001. He has completed Master’s degree in Ophthalmology in 2006 and MD and PhD in 2011 from Faculty of Medicine, Alexandria University, Egypt. He is a Lecturer and Staff University Member of Ophthalmology Department of Alexandria Medical School. He is a Consultant of Orbit, Lid, and Lacrimal Surgery in the Alexandria University Hospitals. Also, he is a skilled Cataract and Refractive Surgeon. He is currently a Consultant Ophthalmologist in Al-Jedanny Hospital, Jeddah, Kingdom of Saudi Arabia.
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