Endoscopic dacryocystorhinostomy: An evaluation for lacrimal patency and eye watering recurrence

Ha Huy Thiên Thanh, Nguyen Quoc Anh, Pham Thi Khanh Van

Main Article Content

Abstract

Endoscopic dacryocystorhinostomy (DCR) has nowadays become the first choice in the management of nasolacrimal duct obstruction. The aims of this study were to describe the anatomic success rate and the causes of failure after DCR. This was a prospective study on 84 cases with endoscopic DCR. All patients were examined to assess lacrimal patency and ostium opening through nasal endoscopic examination. The rate of anatomic patency gradually decreased to 86.91% 6 months after surgery, then remained stable up to 12 months. 63.64% failures had more than one cause. The most common causes were fibrotic scarring of the ostium (100%) and obstruction of the common canaliculus (27.27%). To conclude, DCR helps with lacrimal patency. However, failures existed and the most common causes of recurrence are ostium fibrosis and obstruction of common canaliculus.

Article Details

References

1. Sibley D, Norris JH, Malhotra R. Management and outcomes of patients with epiphora referred to a specialist ophthalmic plastic unit. Clin Exp Ophthalmol. 2013;41(3):231-238.
2. Harish V, Benger RS. Origins of lacrimal surgery, and evolution of dacryocystorhinostomy to the present. Clin Exp Ophthalmol. 2014;42(3):284-287.
3. Vinciguerra A, Nonis A, Giordano Resti A, Bussi M, Trimarchi M. Best treatments available for distal acquired lacrimal obstruction: A systematic review and meta-analysis. Clin Otolaryngol. 2020;45(4):545-557.
4. Huang J, Malek J, Chin D, et al. Systematic review and meta-analysis on outcomes for endoscopic versus external dacryocystorhinostomy. Orbit. 2014;33(2):81-90.
5. Ali MJ, Psaltis AJ, Ali MH, Wormald PJ. Endoscopic assessment of the dacryocystorhinostomy ostium after powered endoscopic surgery: behaviour beyond 4 weeks. Clin Exp Ophthalmol. 2015;43(2):152-155.
6. Leong SC, Macewen CJ, White PS. A systematic review of outcomes after dacryocystorhinostomy in adults. Am J Rhinol Allergy. 2010;24(1):81-90.
7. Mak ST, Io IY, Wong AC. Prognostic factors for outcome of endoscopic dacryocystorhinostomy in patients with primary acquired nasolacrimal duct obstruction. Graefes Arch Clin Exp Ophthalmol. 2013;251(5):1361-1367.
8. Vinciguerra A, Nonis A, Resti AG, Barbieri D, Bussi M, Trimarchi M. Influence of Surgical Techniques on Endoscopic Dacryocystorhinostomy: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg. 2020:194599820972677.
9. Olver JM. The success rates for endonasal dacryocystorhinostomy. Br J Ophthalmol. 2003;87(11):1431.
10. Erdol H, Akyol N, Imamoglu HI, Sozen E. Long-term follow-up of external dacryocystorhinostomy and the factors affecting its success. Orbit. 2005;24(2):99-102.
11. Cohen O, Amos I, Halperin D, et al. Five- and 10-Year Outcomes for Primary Endoscopic Dacryocystorhinostomy: Failure Rate and Risk Factors. Laryngoscope. 2021;131(1):10-16.
12. Dave TV, Mohammed FA, Ali MJ, Naik MN. Etiologic analysis of 100 anatomically failed dacryocystorhinostomies. Clin Ophthalmol. 2016;10:1419-1422.
13. Lin GC, Brook CD, Hatton MP, Metson R. Causes of dacryocystorhinostomy failure: External versus endoscopic approach. Am J Rhinol Allergy. 2017;31(3):181-185.
14. Timlin HM, Kang S, Jiang K, Ezra DG. Recurrent epiphora after dacryocystorhinostomy surgery: Structural abnormalities identified with dacryocystography and long term outcomes of revision surgery : Success rates of further surgery following failed dacryocystorhinostomy surgery. BMC Ophthalmol. 2021;21(1):117.
15. Welham RA, Wulc AE. Management of unsuccessful lacrimal surgery. Br J Ophthalmol. 1987;71(2):152-157.