Lacrimal surgery success after external dacryocystorhinostomy: functional and anatomical results using strict outcome criteria.
Ophthalmic Plast Reconstr Surg
; 25(6): 472-5, 2009.
Article
em En
| MEDLINE
| ID: mdl-19935252
ABSTRACT
PURPOSE:
To present the results of external dacryocystorhinostomy (ext-DCR) for epiphora using strict outcome criteria and provide an accurate baseline and evidence from which to compare the results of endonasal dacryocystorhinostomy.METHODS:
Retrospective case notes review of 158 consecutive adult patients who underwent primary ext-DCR. Functional success was assessed according to the patients' symptoms and anatomical success was measured using objective tests of lacrimal system patency 1) the functional endoscopic dye test and/or endoscopic endonasal inspection of the ostium; 2) syringing of the lacrimal system; and 3) the fluorescein dye retention test. Patients without complete follow-up data were recalled for clinical reevaluation. A minimum follow-up of 6 months was required. Comparison of overall functional and anatomical success was further analyzed according to etiology using logistic regression and for different grades of surgeon using the chi-squared test.RESULTS:
The results for 124 of 158 ext-DCRs showed an overall functional success of 69% and anatomical success of 74%. Patients with primary acquired nasolacrimal duct obstruction (PANDO) who had surgery by the specialist lacrimal surgeon had high success 83% functional success and 100% anatomical success. Patients with watering eyes from non-PANDO aetiology including canalicular disease who had surgery by the specialist lacrimal surgeon had moderate success 78% functional success and 70% anatomical success. The results of all surgery by trainees were lower but only significantly so for PANDO. The mean duration of follow-up was 2.6 years (range, 6 months to 8.3 years); median follow-up was 1.9 years.CONCLUSION:
This study used strict criteria to assess functional and anatomical outcomes of primary ext-DCR and thus provide baseline measures of success with a minimal follow-up of 6 months. When canalicular disease was excluded, results for PANDO were higher. Surgery performed by the specialist lacrimal surgeon had higher success rates than when performed by trainee.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dacriocistorinostomia
/
Aparelho Lacrimal
Tipo de estudo:
Observational_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Ophthalmic Plast Reconstr Surg
Assunto da revista:
OFTALMOLOGIA
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Reino Unido