The Long-Term Follow-Up Results of External Dacryocystorhinostomy Skin Incision Scar with "W Incision''

Objective: To determine the effect of "W incision'' instead of classical vertical incision at external DCR on scar formation. Materials and Methods: Patients with acquired nasolacrimal duct obstruction (NLDO) who were treated with external DCR with classical vertical incision, and patients who were treated with external DCR with "W incision'' were included in the study. The first 39 eyes were operated with a vertical incision, and the remaining 37 eyes were operated with a "W incision''. All the skin incision scars of the patients were assessed and scored by at least the 6th month. The assessment was made by both the patients themselves, and by an ophthalmologist other than the surgeon himself, each scored the incision scar separately (single-masked study). Scores for both groups were compared, and statistical analyses were performed. Results: Self-assessment scores for the incision scar were Grade 2.28 +/- 0.94 in the Vertical incision group, and Grade 1.68 +/- 0.57 in the "W incision'' group (p<0.01). The "W incision'' scar formation was significantly less noticable than the Vertical incision scar formation. Similarly, the assessment scores of the ophthalmologist other than the surgeon himself were significantly lower for the "W incision'' group than for the Vertical incision group. The mean scar assessment scores were Grade 2.13 +/- 0.95 in the Vertical incision group, and Grade 1.57 +/- 0.68 in the "W incision'' group (p<0.01). Conclusion: Skin scar tissue was found to be significantly reduced with a "W incision'' in external DCR operations.