A comparative study of Dacryocystorhinostomy with canalicular silicone tube intubation & application of Mitomycin-C in failed cases of chronic dacryocystitis

Authors: Dr Niraj Kumar Yadav, Dr Deepti Joshi, Dr Priyanshi Priya, Dr Apjit Kaur, Dr Anil Kumar Srivastava

DOI: 10.18231/j.ijceo.10956.1758524481

Keywords: Chronic Dacryocystitis,Dacryocystorhinostomy,Silicone tube,Canalicular intubation,Mitomycin-C,Failed DCR,Re-dacryocystorhinostomy

Abstract: Introduction- Chronic dacryocystitis is a chronic infection and inflammation of the lacrimal sac due to blockage of the nasolacrimal duct, leading to constant watering and ocular discharge. Common causes of failed DCR surgery are Stenosis of the common canalicular opening in the sac, sump syndrome, high anastamosis of flap, Poor surgical procedure. Purpose - To compare the post operative surgical outcome in failed cases of chronic dacryocystitis. Materials & Methods- The present study was prospective, interventional, comparative, and single-centric, and it occurred at a tertiary care center for a period of one year. A total of failed cases operated elsewhere were included in the study and divided into two groups, 30 patients in each group, through random sampling. After proper history and examination, all patients underwent re-dacryocystorhinostomy with silicone tube intubation and application of Mitomycin-C over flap and circumosteal area. In group A the silicon tube was removed at the end of 4 weeks while in group B it was removed at the end of 6 weeks. The post operative surgical outcomes were compared at the end of 3 months. Results- The success rate of second time External Dacryocystorhinostomy with silicon tube intubation was 90% in group A when silicon tube was removed at 4 weeks while in group B it was increased to 100% when silicon tube removed at 6 weeks. Conclusion- External DCR surgery using canalicular silicone tube intubation, combined with intraoperative mucosal flap and circumosteal application of Mitomycin-C, can lead to excellent outcomes. The post operative result was higher with significant deference in patients where silicone tube was removed at 6th post operative weeks.