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A.R. Malik, M.A. Elgohary, M. Toma, A. McElvanney; Functional Outcome of Endonasal versus External Dacryocystorhinostomy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2422.
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Purpose: To compare the outcome of endonasal DCR (End-DCR) to external DCR (Ext-DCR). Methods: As part of an audit, the medical notes of all patients who underwent End-DCR (n=14) at a general ophthalmic unit were reviewed and the functional results compared to a contemporary age-matched group who had ext-DCR (n=12). Both procedures were done under general anaesthesia and silicone tubes were used in all cases. Patients follow-up was for a minimum of 4 months and epiphora was evaluated subjectively using Munk's grading questionnaire. Results: Patients were comparable in their preoperative Munk's grade (p=0.97). Both En-DCR and Ext-DCR procedures significantly reduced patients' grade of epiphora (p= 0.01and 0.008, respectively). Postoperatively, 64% in the En-DCR versus 67% in the Ext-DCR had symptomatic improvement and no significant difference was found in the proportion of patients attaining substantial improvement i.e. Munk's grades 0 or 1between the two groups (31% vs. 50%; p=0.4). Conclusion: Both procedures of DCR are comparable in reducing patients' symptom of epiphora through effectively improving tear drainage function and hence the choice of the procedure should be based on surgeon's expertise and patient preference.
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