J Korean Ophthalmol Soc.  2015 Nov;56(11):1661-1666. 10.3341/jkos.2015.56.11.1661.

Prognostic Factors for Successful Endonasal Dacryocystorhinostomy

• Shin IH
• Lim HB
• Lee JJ
• Lee SB

• KMID: 2214171
• DOI: http://doi.org/10.3341/jkos.2015.56.11.1661

Abstract

PURPOSE
To evaluate the factors useful for predicting the surgical outcome of endonasal dacryocystorhinostomy.
METHODS
This retrospective observational study included 117 eyes of 94 patients with nasolacrimal duct obstruction who underwent endonasal dacryocystorhinostomy and were followed up for more than 6 months. Factors associated with successful surgery were analyzed based on the preoperative and intraoperative factors and postoperative clinical features. Preoperative factors such as age, gender, laterality, presence or absence of hypertension, and diabetes were analyzed. Intraoperative factors such as use of triamcinolone, removal of uncinate process or middle turbinate during surgery, and location of the sac were analyzed. The postoperative clinical features including high tear meniscus, no intranasal silicone tube movement, and no air reflux feeling were each given a score of 1. Based on aggregate score, the patients were divided into 2 groups, the high score and low score groups and analyzed accordingly.
RESULTS
The success rate was 91.5%. Patients with diabetes showed a significantly low success rate (73.3%, p = 0.007). In patients with high tear meniscus at 3, 6, and 9 weeks after surgery, the success rate was significantly low (76.9%, 81.8% and 75.0%; p = 0.003, p = 0.029 and p = 0.002, respectively). The low score group at 3 and 6 weeks after surgery showed a significantly high success rate (100% and 95.9%; p < 0.001 and p = 0.023, respectively).
CONCLUSIONS
Besides preoperative and intraoperative factors, the early postoperative clinical features are important for predicting the success of the surgery. If tear meniscus is high and there is no intranasal silicone tube movement and air reflux from the punctum in the early stages after surgery, more active management from the initial treatment is needed.

Keyword

Endonasal dacryocystorhinostomy; Nasolacrimal duct obstruction; Prognostic factors; Success rate

MeSH Terms

Dacryocystorhinostomy*
Humans
Hypertension
Nasolacrimal Duct
Observational Study
Retrospective Studies
Silicones
Tears
Triamcinolone
Turbinates
Silicones
Triamcinolone

Figure

• 

  Figure 1. Relationship between clinical score and final success according to the time. Success rates in high score group are lower at 3 weeks, 6 weeks, and 9 weeks after surgery than those in low score group. Especially the success rates on 3 and 6 weeks show a statistically significant difference. * Chi-square test.

Reference

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