Learning Curve in External DCR – A Trainee’s Perspective

Authors

  • Karan Bhatia Regional Institute of Ophthalmology, Sitapur Eye Hospital, Sitapur Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry M. M. Joshi Eye Institute, Gokul Road
  • Sabyasachi Sengupta Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry
  • Madhu Bhadauria Regional Institute of Ophthalmology, Sitapur Eye Hospital, Sitapur, Uttar Pradesh

DOI:

https://doi.org/10.3126/nepjoph.v9i2.19255

Keywords:

dacryocystorhinostomy, acquired nasolacrimal duct obstruction.

Abstract

Purpose: The aim of this study is to determine the success rate over time in patients undergoing External Dacryocystorhinostomy (DCR) with acquired naso-lacrimal duct obstruction (NLDO), when done by a trainee ophthalmologist.

Methods: The study was Prospective Observational study and was conducted in Tertiary Eye Hospital, Uttar Pradesh, India. One hundred and fourteen consecutive adult patients underwent external DCR for acquired complete NLDO by a trainee with less than 3 years of experience in ophthalmology between November 2011 and March 2013. Postoperative anatomic success rate was determined at 6 months on the basis of the patency of lacrimal sac syringing and patients were asked to subjectively evaluate improvement of their epiphora using a questionnaire.

Results: Anatomical success rate across the entire study period was 93.7% and this improved from 87% in the first tertile of 38 patients to 94% in the second tertile and 100% in the final tertile of cases (p<0.05). Overall complication rate was 16.67% and reduced from 29% in the first tertile to 8% in the final tertile (p<0.05). Loss of anterior nasal flap was the commonest complication (10 cases) during the training period.

Conclusion: External DCR, as a primary procedure for acquired NLDO, even when operated by trainee ophthalmologists, has a relatively high success rate that improves over time. As the learning curve improves, complication rates reduce significantly. Financial Disclosure: No author has any financial or proprietary interest in the material or method mentioned.

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Published

2018-02-21

How to Cite

Bhatia, K., Sengupta, S., & Bhadauria, M. (2018). Learning Curve in External DCR – A Trainee’s Perspective. Nepalese Journal of Ophthalmology, 9(2), 121–127. https://doi.org/10.3126/nepjoph.v9i2.19255

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Section

Original Articles