title: A randomized study comparing DCR with and without excision of the posterior mucosal flap.
abstract: OBJECTIVE
  A prospective randomized study was carried out to compare the success rate of external dacryocystorhinostomy (DCR) with and without excision of the posterior sac mucosal flap.
  
  
  METHODS
  Forty patients (Group A) underwent DCR without excision of the posterior sac mucosal flap, and the results obtained were compared with those of another series of 40 patients (Group B) where DCR was performed with excision of the posterior sac flap. A large posterior flap was excised from the lacrimal sac and a large, mobile, anteriorly-hinged, nasal mucosal flap was fashioned. The latter was joined to the anterior sac flap using a 6/0 double-armed polyglycolic acid suture.
  
  
  RESULTS
  Four patients in Group B had signs and symptoms of tearing (90% success rate) at the end of the follow-up period (mean 11.05 months, range 9-14 months). Group A had six patients with recurrent signs and symptoms (85% success rate) by the end of a mean follow-up period of 11.3 months (range 9-14 months).
  
  
  CONCLUSIONS
  Excision of the posterior sac mucosa may improve the success rate of external DCR.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Ain Shams University, 30 Ibn Al-Nafees Street, District 6, Nassr City, Cairo 11371, Egypt. elwan@mailcity.com
authors.forename: Sherif
authors.initials: S
authors.lastname: Elwan
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000601:surgery*; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome