a survey of 200 dcr operations

in a prospective survey, 200 cases of operated chronic dacryocystitis were divided into three groups according to the kind of operation, and the respective results are as follows: group i includes 100 cases in whom the lacrimal bone was removed (8mm x 8mm) and a 6mm diameter catheter was used (as a duct between the lacrimal sac and nasal cavity). the recurrence rate within one year was 24 % . group ii consists of 50 patients in whom a hole about 17mm x 17mm was made (in the lacrimal sac area at the orbit), an 8mm diameter catheter was installed and anterior mucosal flaps were repaired. this technique led to 95% recovery. group iii consists of 50 cases who underwent the same technique as group ii without using the catheter and by repairing both anterior and posterior mucosal flaps. the result was 98% successful. in conclusion, the following are suggested as the major factors determining successfulness of dcr operations. 1. removing the bone around the lacrimal sac about 17 x 17mm, 2. releasing the lacrimal sac from the adjacent bone, 3. making an incision at the third inferior part of the lacrimal sac, 4. identifying the lacrimal sac exactly, and 5. making free direct communication between the nasal cavity and the lacrimal sac.