Comparative study of the direct closure of surgical incision for external dacryocystorhinostomy using 6-0 Prolene versus Dermabond ®.

Purpose: In this study, we aimed to compare closure of the incision for external dacryocystorhinostomy (ext-DCR) by suturing with 6-0 Prolene versus closure with 2-octyl cyanoacrylate and assess the results in terms of the aesthetic and functional aspects of the scar, operating time, postoperative symptoms and complications, and the economic cost of the two techniques.

Methods: Sixty-three patients with distal lacrimal obstruction and indication of ext-DCR were initially enrolled in a longitudinal prospective cohort study. Patients underwent ophthalmologic evaluations including lacrimal probing, external examination with photograph, measurement of the surgical wound, timing the cutaneous closure phase of the surgery, recording postoperative wound pain using visual analog scale (VAS), and recording the patient's and clinician's subjective satisfaction with the scar using Patient and Observer Scar Assessment Scale (POSAS) at 6 months postsurgery. The 63 eyes were divided into two groups: the wounds in group 1 were closed with 6-0 Prolene using continuous locking suture and the wounds in group 2 were closed with 2-octyl cyanoacrylate.

Results: There was no difference in baseline characteristics (age, sex, and race), and no statistically significant differences were found in wound length, POSAS score, VAS score, or serious complications of the wound between the two groups. There were differences in surgery time and economic cost for group 2 compared to group 1 of -2.39 min and -€5.37/operation, respectively.

Conclusion: This is the first study in the literature that compares 6-0 Prolene versus Dermabond ® . The latter one presents advantages compared to Prolene, given that it reduces the length of surgery, reduces costs, and allows for greater flexibility in postoperative follow-up visits.