title: Assessment of anterior suspended flaps modification for external dacryocystorhinostomy.
abstract: OBJECTIVE
  The aim of this study was to evaluate the functional and/or anatomic success rate as well as complications of anterior suspended flaps modification for external dacryocystorhinostomy (DCR).
  
  
  METHODS
  This is a retrospective study that included 50 eyes of 47 patients who underwent anterior suspended flap external DCR surgery for nasolacrimal duct obstruction. Diagnosis of nasolacrimal duct obstruction was made through irrigation of the nasolacrimal drainage system. Anterior flaps of lacrimal sac and nasal mucosa, as large as possible, were created in all patients. Posterior flaps of lacrimal sac and exposed nasal mucosa were excised. After suturing the anterior flaps with two 6-0 Vicryl sutures, the third suture was passed through the orbicularis oculi at the subcutaneous level on 1 edge of incision, then from the middle of the anterior flaps and the other edge of the incision to the suspended anterior flaps.
  
  
  RESULTS
  The success rate of 50 surgeries was 96%. In 37 eyes, no problems were reported during the surgery and the modified external DCR was performed successfully. The success rate of the modified external DCR was 100% in those patients. The average operation time was 34 ± 8.2 minutes.
  
  
  CONCLUSIONS
  These results suggest that anterior suspended flap external DCR is a simple, safe technique with a very high success rate and a satisfactory surgical time.
authors.affiliation: Department of Ophthalmology, Dumlupinar University School of Medicine, Kutahya, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tetikoglu
authors.forename: Haci Murat
authors.initials: HM
authors.lastname: Sagdik
authors.forename: Fatih
authors.initials: F
authors.lastname: Ozcura
authors.forename: Serdar
authors.initials: S
authors.lastname: Aktas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000637:transplantation*; D012189:Retrospective Studies; D013524:Surgical Flaps; D055815:Young Adult