| Prognostic Factors for Successful Endonasal Dacryocystorhinostomy. |
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Il Hwan Shin, Hyung Bin Lim, Jong Joo Lee, Sung Bok Lee |
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Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea. sblee@cnu.ac.kr |
| 성공적인 코경유 눈물주머니코안연결술의 예측인자 |
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신일환⋅임형빈⋅이종주⋅이성복 |
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충남대학교 의학전문대학원 안과학교실 |
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Received: 12 June 2015 • Revised: 23 June 2015 • Accepted: 4 September 2015 |
| 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. |
| Key Words:
Endonasal dacryocystorhinostomy;Nasolacrimal duct obstruction;Prognostic factors;Success rate |
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