title: Cosmetic evaluation of surgical scars after external dacryocystorhinostomy.
abstract: OBJECTIVE
  To evaluate the surgical scars of external dacryocystorhinostomy (DCR) cosmetically.
  
  
  METHODS
  Totally 50 consecutive cases of primary acquired nasolacrimal duct obstruction (PANDO) were included in the study. Surgical scars were assessed by the patients and two independent observers at 2, 6 and 12wk postoperatively on the basis of visibility of the scars and still photographs respectively and were graded from 0-3. Kappa test was utilised to check the agreement of scar grading between the two observers. Wilcoxan signed ranks test was used to analyse the improvement of scar grading.
  
  
  RESULTS
  Thirty-four (68%) patients graded their incision site as very visible (grade 3) at 2wk. At 6 and 12wk, incision site was observed as grade 3 by 7 (14%) and 1 (2%) patients respectively. Photographic evaluation of patients by 2 observers showed an average score of 2.75, 1.94 and 0.94 at 2, 6 and 12wk respectively. Change in scar grading from grade 3 to grade 0 in consecutive follow-up (2, 6 and 12wk) was found to be highly significant both for the patient as well for the observers (P<0.0001).
  
  
  CONCLUSIONS
  The external DCR is a highly effective and safe procedure and in view of low percentage of cases who complained of marked scarring in the present study, thus scarring should not be the main ground for deciding the approach to DCR surgery, even in young cosmetically conscious patients.
authors.affiliation: Institute of Ophthalmology, Jawaharlal Nehru Medical College, AMU, Aligarh.UP 202002, India.
authors.forename: Syed Ali Raza
authors.initials: SA
authors.lastname: Rizvi
authors.affiliation: Institute of Ophthalmology, Jawaharlal Nehru Medical College, AMU, Aligarh.UP 202002, India.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Saquib
authors.affiliation: Institute of Ophthalmology, Jawaharlal Nehru Medical College, AMU, Aligarh.UP 202002, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Maheshwari
authors.affiliation: Institute of Ophthalmology, Jawaharlal Nehru Medical College, AMU, Aligarh.UP 202002, India.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Gupta
authors.affiliation: Department of Oto-Rhino-Laryngology, Jawaharlal Nehru Medical College, AMU, Aligarh.UP 202002, India.
authors.forename: Zafar
authors.initials: Z
authors.lastname: Iqbal
authors.affiliation: Department of Oto-Rhino-Laryngology, Era's Lucknow Medical College and Hospital, Lucknow.UP 226003, India.
authors.forename: Puneet
authors.initials: P
authors.lastname: Maheshwari
keywords: cosmetic; external dacryocystorhinostomy; primary acquired nasolacrimal duct obstruction; surgical scar