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Comparative Study
. 2019 Jul;67(7):1143-1147.
doi: 10.4103/ijo.IJO_1889_18.

External dacryocystorhinostomy conventional surgery versus Pawar implant: A comparative study

Deepak Mishra  1 , Prashant Bhushan  1 , Bibhuti P Sinha  2 , Gyan Bhaskar  2 , Raksha Rao  3
Affiliations
Comparative Study

External dacryocystorhinostomy conventional surgery versus Pawar implant: A comparative study

Deepak Mishra et al. Indian J Ophthalmol. 2019 Jul.

Abstract

Purpose: External dacryocystorhinostomy (DCR) surgeries are cost-effective with excellent success rates. The present study was designed to compare the safety and efficacy of conventional external DCR versus external DCR using Pawar silicone implant in chronic dacryocystitis.

Methods: This is a prospective, comparative, interventional case series over a period of 18 months with patients managed by external DCR surgery with and without Pawar implant. Institutional review board approval was obtained before the study. The success of the surgery was objectively measured by sac patency on syringing at the last follow up.

Results: A total of 65 patients with chronic dacryocystitis were included in the study. The mean age of patients in the series was 41.43 years (median, 41 years; range, 12 years-60 years). All patients presented with epiphora (100%) and underwent external DCR and were chosen for conventional surgery (n = 33, 51%, group 1) or Pawar silicone implant surgery (n = 32, 49%, group 2) on a random basis. The mean duration of the surgery from the time of skin incision to skin closure for group 1 was 27.7 minutes (median, 26 minutes; range, 21-30 minutes) while in group 2, it was 75.5 minutes (median, 75 minutes; range, 60-88 minutes), which was statistically significant (P < 0.01). The success rate of the procedure done in group 1 was 90% which increased to 97% after the management of failed cases as compared to the success rate in group 2 of 91% and 94%, before and after the management of failed cases, respectively.

Conclusion: External DCR using Pawar implant is a safe surgery which is faster than conventional external DCR with almost equal success rates between both the procedures.

Keywords: Chronic dacryocystitis; Pawar's implant; dacryocystorhinistomy; lacrimal; nasolacrimal duct obstruction.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Pawar intracystic implant with a proximal wide collar to help in anchorage around the lacrimal sac and a distal tune that rests at the ostium
Figure 2
Figure 2
Technique of implant DCR. (a) A small skin incision and meticulous dissection to expose the lacrimal sac. (b) Pawar implant being placed within the sac using an introducer. (c) After anchoring the implant in the sac, anterior sac flap is sutured to the anterior nasal mucosal flap. (d) Skin incision after subcutaneous tissue approximation
See this image and copyright information in PMC

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