Dacryocystorhinostomy at Ramathibodi Hospital.
Two hundred and seventy patients with idiopathic obstruction of the lacrimal passage between the sac and the nasolacrimal duct, who underwent external dacryocystorhinostomy at the Department of Ophthalmology, Ramathibodi Hospital were studied retrospectively. All the patients had the operations between 1983 and 1987; 240 were female (88.9%) and 30 were male (11.1%), with, a ratio of 8 female to 1 male. The ages ranged from 3 to 83 years, with the peak in the 46-55 age group (25.19%). The overall surgical success rate was 86.5 per cent, the definition for success being a relief of the obstruction as evident symptomatically and by the ability to irrigate the saline from the puncta to the nasal cavity at follow-ups of more than 21 days postoperatively. The patients were further subdivided into the "silastic" group and the "non-silastic" group: and the success rate were 75.5 and 95.7 per cent respectively. Significant complications of the dacryocystorhinostomy were recorded in 11 cases; 2 wound infections, 2 lacrimo-cutaneous fistulae, 5 severe operative hemorrhage and 2 ethmoidal sinus involvement.