Nonendoscopic endonasal dacryocystorhinostomy: Outcome in 134 eyes

AIMS: To evaluate the outcome of nonendoscopic endonasal dacryocystorhinostomy (NEN-DCR) in patients with nasolacrimal duct obstruction (NLDO) in India. METHODS: Retrospective case series of NEN-DCR between July 2012 and October 2014. All patients had follow-up >3 months. Success was defined anatomically as patency on irrigation and functionally as relief from epiphora. STATISTICAL ANALYSIS USED: Fischer's exact test and Chi-square test. RESULTS: A total of 122 patients (134 eyes; 81 female; mean age 37 ± 18 years) were included. Indications were primary acquired NLDO in 92 (68%) eyes of adults (>18 years), NLDO in children (<18 years) in 22 eyes (16%), acute dacryocystitis in 13 eyes, failed prior DCR in six eyes, and secondary acquired NLDO in one eye. Mean duration of surgery was 36 min (range: 16–92). At a median follow-up of 6 months (range: 3–15), 86% eyes had functional success and 85% had anatomical success. Revision NEN-DCR was successful in 13/16 eyes. All patients with acute dacryocystitis were completely symptom-free at final visit. In children, (17/22) 77% achieved functional success after primary NEN-DCR which improved to 100% after one revision. Tube-related epiphora and granuloma in ten eyes resolved after removal. CONCLUSION: NEN-DCR gives good outcome in primary NLDO and is also effective in those with acute dacryocystitis and in children with NLDO. The technique obviates the need for an endoscope and has an acceptable safety profile and thus may be particularly suited for the developing nations.