External dacryocystorhinostomy: Assessing factors that influence outcome

Vivek B. Pandya, Scott Lee, Ross Benger, Jenny J. Danks, Gina Kourt, Peter A. Martin, Somsak Lertsumitkul, Peter McCluskey, Raf Ghabrial*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    19 Citations (Scopus)

    Abstract

    Purpose: To present the experience of external dacryocystorhinostomy (DCR) at a tertiary referral center and investigate factors that may affect clinical outcomes. Methods: The clinical records of all patients who underwent external DCR at Sydney Eye Hospital between May 2000 and August 2007 were reviewed. Data were collected in regards to patient demographics, preoperative assessment, operative details, surgical technique, postoperative management, and clinical outcomes. This information was then analyzed, with emphasis on factors that influence surgical outcomes and success. Results: A total of 338 cases were reviewed. The mean age at time of surgery was 64.82 years and the majority of patients were female (65%). Epiphora was the major preoperative symptom. Assisted local anesthesia and day stay surgery were the most common surgical settings. There was a statistically significant difference in theatre time between consultant and trainee surgeons (P < 0.00001). The mean final follow-up time was 11 months. Overall, 77.3% of patients had full resolution of symptoms and 20.8% had partial resolution. Only five patients (1.9%) had no resolution of symptoms. There was no significant difference in outcomes between consultants and trainees. Patients with anatomical nasolacrimal obstruction had significantly better outcomes compared with functional obstruction (P0.04). The postoperative fluorescein dye disappearance test was a good predictor of clinical success (P0.005). Silicone intubation for greater than 6 months was associated with better outcomes (P0.002). Conclusions: The results at our tertiary center are comparable to results stated in the literature. In our series, only the amount of nasolacrimal obstruction and duration of postoperative intubation influenced surgical success.

    Original languageEnglish
    Pages (from-to)291-297
    Number of pages7
    JournalOrbit
    Volume29
    Issue number5
    DOIs
    Publication statusPublished - Oct 2010

    Keywords

    • External dacryocystorhinostomy
    • Lacrimal
    • Nasolacrimal duct obstruction

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