Salil Kumar Mandal1 , Purban Ganguly2 , Nazibul Hasan Mallick3 , Pankaj Shil4 , Oishik Sarkar5 , Anwesha Maitra6
BACKGROUND We wanted to evaluate the surgical outcome and long-term efficacy of intubation DCR with double threaded 1 - 0 silk in failed dacryocystorhinostomy. The efficacy of 1 - 0 silk suture used as stent material in revision DCR surgery has been scientifically scrutinized. METHODS This prospective, observational clinical study was done over a period of two years. A total of 40 patients with unilateral NLD block due to failed DCR was selected. Single anterior flap or no flap DCR surgery was performed with the insertion of double threaded silk sutures by means of stent in all the cases. In the postoperative period, this loop of thread was rotated clockwise and anticlockwise for two months. Syringing was done every week in the 1 st month and twice in a week for next one month. Patients were followed up for next one year. RESULTS Out of 40 patients, 16 were male and 24 were female. Age of patients ranged from 18 to 55 years. Causes of failures included endoscopic DCR 7 (17.5 %), external DCR 30 (75 %), and primary silicon intubation DCR 3 (7.5 %). Newly made bone ostium’s’ diameters ranges from 14 mm to 16 mm. Single anterior flaps were performed in 26 (65 %) cases and no flaps in 14 (35 %) cases. Out of 40 cases, Epiphora and discharge from the puncta resolved in 34 cases. Success rate was 85 %. In all cases, double threaded 1 - 0 silk was introduced for active stent. Symptomatic post-operative epiphora was present at the end of one year in 6 (15 %) patients. CONCLUSIONS Intubation dacryocystorhinostomy with double threaded 1 - 0 silk suture in failed DCR is surgically functional and anatomically effective in developing countries. This surgical procedure is easy to perform with anyone in rural and urban setup. It is easily accessible and acceptable to everybody. Moreover, 1 - 0 silk suture is readily available. It is a very cost-effective procedure.
