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Table 1 Age and gender distribution(略)
On the other hand, suturing the posterior flaps often constitutes a difficulty and may take a considerable amount of time, particularly in the presence of hemorrhage in DCR surgery. Several options have been described for management of the posterior flaps. The posterior flaps can be anastomosed, excised, or not fashioned at all. A study by Elwan[16] found statistically similar success rates by the end of a mean followup period of 11 months when comparing excision of the posterior flaps to posterior flaps not be fashioned at all.
In this study, only anterior single flap is sutured to the margin of periosteum at the anterior lacrimal crest. The Ushaped configuration of the created flap allows easier suturing of sac and periosteal flaps.
Although it is simpler and easier to master the surgical technique, anterior single flap DCR shows a success rate comparable to that obtained by the more complex conventional DCR. This gives this procedure an advantage over the conventional one. However, a randomized trial is needed to statistically compare between the two procedures and validate this conclusion.
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