Evaluation of efficacy of amniotic membrane in preventing failures in external dacryocystorhinostomy

To Evaluate the efficacy of Amniotic Membrane in preventing failures in external Dacryocystorhinostomy.

It was a prospective randomized comparative study of external DCR and external DCR with AM. It was conducted at S. Nijalingappa Medical College, Bagalkot between October 2015 and April 2016.

The study included 100 cases with primary Nasolacrimal Duct obstruction or chronic dacryocystitis. Fifty patients underwent external DCR and 50 patients underwent external DCR with Amniotic Membrane. The results were compared at the end of 6months follow up.

100 cases were randomized into 2 groups. Group I underwent External DCR and Group II underwent DCR with AM. Maximum incidence of disease was in 41–50 age group with 62% female patients and 38% males. Chronic Dacryocystitis was the commonest cause (88%) followed by mucocele (12%). The intra operative, post operative complications encountered in both the groups were identical. Time required for surgery was comparable between two groups, the extra time needed in group II was for the application of AM. A total success rate of 84% was observed in group I and 90% in group II.

In conclusion, though the success rate is higher in DCR with AM, it is not statistically significant (p>0.05). Anti-fibroblastic activity of AM in preventing the scarring at osteotomy site in external DCR can go a long way in preventing the re-blockage and maintaining the post-operative patency of passages. Taking into consideration the long term side effects of Mitomycin C, AM can be considered as a simple and effective modification of conventional external DCR.