title: Comparison of the effect of W-shaped and linear skin incisions on scar visibility in bilateral external dacryocystorhinostomy.
abstract: BACKGROUND
  The aim of this study was to compare the effect of W-shaped skin (WS) and linear skin (LS) incisions on cutaneous scar tissue formation in patients who have undergone bilateral external dacryocystorhinostomy.
  
  
  METHODS
  Sixteen patients (14 females and two males) with acquired bilateral nasolacrimal duct obstruction were included in this prospective, interventional comparative study. LS incision was applied to one side and WS skin incision to the other side. The skin incisions were assessed 6 months after each procedure by the patients themselves and by two ophthalmologists who were unaware of the skin incision shape and side. Scar tissue that was not recognized under the same light conditions and in the same room from a 100 cm distance was recorded as grade 1. Minimally visible scar tissue was assessed as grade 2, moderately visible scar tissue as grade 3, and easily visible scar tissue as grade 4.
  
  
  RESULTS
  The mean scar assessment scores recorded by the first ophthalmologist were 2.50±0.82 for the LS group and 1.25±0.45 for the WS group (P<0.001). The second ophthalmologist's assessment scores were 2.25±0.86 for the LS group and 1.25±0.45 for the WS group (P<0.001). The mean patient self-assessment score for the incision scars was 2.44±1.03 for the LS group and 1.56±0.73 for the WS group (P<0.001).
  
  
  CONCLUSIONS
  Compared with LS incision, WS incision resulted in less cutaneous scar tissue formation in patients who have undergone bilateral external dacryocystorhinostomy.
authors.affiliation: Department of Ophthalmology, University of Kafkas, Sarikamis, Kars.
authors.forename: Metin
authors.initials: M
authors.lastname: Ekinci
authors.affiliation: Department of Ophthalmology, University of Kafkas, Sarikamis, Kars.
authors.forename: Halil Hüseyin
authors.initials: HH
authors.lastname: Caǧatay
authors.affiliation: Department of Ophthalmology, Sarikamis Military Hospital, Sarikamis, Kars.
authors.forename: Gokcen
authors.initials: G
authors.lastname: Gokce
authors.affiliation: Ophthalmology Clinic, Erzurum Training and Research Hospital, University of Atatürk, Erzurum.
authors.forename: Erdinç
authors.initials: E
authors.lastname: Ceylan
authors.affiliation: Department of Ophthalmology, University of Atatürk, Erzurum.
authors.forename: Sadullah
authors.initials: S
authors.lastname: Keleş
authors.affiliation: Department of Ophthalmology, University of Mugla Sıtkı Kocman, Muǧla, Turkey.
authors.forename: Ozgür
authors.initials: O
authors.lastname: Cakici
authors.affiliation: Department of Ophthalmology, University of Kafkas, Sarikamis, Kars.
authors.forename: Mehmet Ersin
authors.initials: ME
authors.lastname: Oba
authors.affiliation: Department of Ophthalmology, University of Kafkas, Sarikamis, Kars.
authors.forename: Zeliha
authors.initials: Z
authors.lastname: Yazar
keywords: W-shaped incision; external dacryocystorhinostomy; linear incision; skin