Bilateral simultaneous external dacryocystorhinostomy: outcomes and patient satisfaction in a single-stage approach.

OBJECTIVE

To evaluate the viability of simultaneous bilateral external dacryocystorhinostomy (ex-DCR) through a multidimensional analysis of surgical feasibility, patient-reported outcomes, complication incidence, and cost-efficacy.

METHODS

The study included 54 eyes of 27 patients who underwent bilateral simultaneous ex-DCR for bilateral symptomatic epiphora due to NLDO. Patient symptoms were systematically assessed using the validated Nasolacrimal Duct Obstruction Symptom Score (NLDO-SS) questionnaire. Additionally, all patients completed a Thurstone scale-based questionnaire to evaluate the surgical process and postoperative period in terms of functional success, psychological relief, overall satisfaction, economic benefits, and medical outcomes.

RESULTS

The mean patient age of 56.5 ± 13.1 years (range: 22-78) at the time of surgery. Postoperatively, the mean NLDO-SS decreased to 12.7 ± 5.7 (range: 2-26), demonstrating a statistically significant reduction in total scores (p < 0.001). The mean surgical duration was 72.0 ± 15.5 min (range: 52-125). No intraoperative or postoperative complications were observed in any patient. Anatomic success was achieved in 53/54 eyes (success rate: 98.1%), while functional success was observed in 52/54 eyes (success rate: 96.2%). Postoperative patient evaluation using the Thurstone scale revealed functional success scores of 4.5 ± 0.8 for the right side and 4.4 ± 0.8, psychological relief (4.6 ± 0.8), overall patient satisfaction (4.7 ± 0.6), economic advantages (4.7 ± 0.5), and medical benefits (4.7 ± 0.5).

CONCLUSION

Our preliminary findings demonstrate that single-session bilateral ex-DCR can be a safe and effective option in appropriately selected patients with high surgical success rates, reasonable operative duration, excellent patient satisfaction, and significant functional improvement without major complications.