Eyelid Incision for Dacryocystorhinostomy in Asians

Abstract

Purpose: Dacryocystorhinostomy via an eyelid incision has been described in Western literature. This study was undertaken to confirm that eyelid incision for dacryocystorhinostomy is suitable in Asians, because Asians have anatomic features that differ from those of Westerners. Methods: We performed dacryocystorhinostomy with an eyelid incision along skin wrinkles or relaxed skin tension lines in 57 eyelids of 49 patients from July 2003 to December 2004. The medical records of the patients were reviewed retrospectively. Results: Postoperative scars were easily camouflaged by wrinkles or relaxed skin tension lines of the eyelid without major complications. Conclusions: An eyelid incision can be used for dacryocystorhinostomy in Asians, regardless of the lack of a definite lower eyelid crease and the presence of epicanthus.

Functional and cosmetic results of a lower eyelid crease approach for external dacryocystorhinostomy

“…Our findings concur well with previous studies concerning the cosmetic aspect of the scar with lower eyelid incision for DCR (2,3) . Lower lid relaxed skin tension lines are horizontal and incisions placed on these lines are hardly noticeable shortly after surgery.…”

Tear Trough Incision for External Dacryocystorhinostomy

“…Their incision started 10 mm medial to the medial canthus, and extended inferiorly and laterally in the first lower eyelid crease. Similarly, Kim et al 29 studied the eyelid crease incision in Asian patients. Their incision was 15 mm to 18 mm in length, did not go medial to the medial canthal tendon, and was placed in the most prominent wrinkle.…”

Aesthetic assessment in periciliary “v-incision” versus conventional external dacryocystorhinostomy in Asians

“…7 (Table 2) The median time until surgical failure was 4.0 months (IQR 2.0-7.5 months). The VDCR group had longer mean time until surgical failure than conventional DCR but without statistical significance.…”

“…For these reasons, external DCR is still being performed frequently. Conventionally, external DCR is performed by vertically incising the lateral nasal wall, and modified techniques of external DCR such as J-shaped, W-shaped, and subciliary incisions have been described either to minimize scar formation [5][6][7][8][9][10][11][12][13] or even to avoid a cutaneous scar through retrocaruncular and transconjunctival approaches [14][15][16][17]. Periciliary incisions near the skin-mucosal junction at the lacrimal portion of the lid margin is performed during V-Y epicanthoplasty to avoid noticeable scar formation in Asians [18][19][20].…”