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ORIGINAL ARTICLE
Year : 2016  |  Volume : 64  |  Issue : 4  |  Page : 261-265

The cosmetic outcome of external dacryocystorhinostomy scar and factors affecting it


1 Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
2 Department of Ophthalmology, Oculoplastic Unit, Faculty of Medicine, Tanta University, Tanta, Egypt

Correspondence Address:
Dr. Molham A Elbakary
Department of Ophthalmology, Oculoplastic Unit, Faculty of Medicine, Tanta University, 31527 Tanta
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.182933

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Purpose: To study the cosmetic outcome of external dacryocystorhinostomy (Ex-DCR) and to detect the factors affecting it. Patients and Methods: Prospective randomized interventional study included forty patients who were treated by 40 Ex-DCRs. In twenty patients, medial canthal vertical incision was used and in the other twenty cases, subciliary incision was used. The skin was closed using vicryl 6-0 or prolene 6-0 interrupted sutures, and each one was randomly used in twenty patients (10 patients of each incision type). Cosmetic outcome was evaluated 6 months postoperative by the patients and by an oculoplastic surgeon on a four grades scale. Cosmetic results and its correlation to patients' age, sex, skin complexion, type of incision, and type of skin sutures were studied. Results: The mean scar grading was 0.98 ± 1.0 and 1.3 ± 1.0 in patients' and examiner's assessment. About 27.5% described their scars as cosmetically significant. The cosmetic outcome was significantly affected by the type of incision with only 5% significant scars in subciliary incision group. Prolene 6-0 suture was associated with better cosmetic results with 15% significant scars. 50% of dark-skinned patients showed cosmetically significant scars. Although no correlation was found between patients' age and cosmetic outcome, pediatric patients showed higher tendency to scar visibility with mean scar grade 1.2 ± 1.0 and 1.5 ± 0.9 in patients' and examiner's assessment. Conclusion: Dark skinned and pediatric patients are more prone to visible Ex-DCR scar. The use of subciliary approach and prolene 6-0 skin sutures is associated with more favorable cosmetic outcome.


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