Clinical outcomes and prognostic factors in patients with nasolacrimal duct obstruction or stenosis using dacryoendoscopy

Abstract

Silicone intubation has emerged as a common option to address nasolacrimal duct obstruction (NLDO) or stenosis. Although dacryoendoscope has increased the success rate of silicone intubation, the success rates were significantly different. Furthermore, no study has comprehensively assessed the risk factors of treatment failure after silicone intubation. In this study, we aim to evaluate the effectiveness of dacryoendoscopic-assisted laser dacryoplasty with silicone intubation (DLDI) for the management of NLDO or stenosis, and to identify the factors associated with treatment failure. A total of 522 patientswith NLDO or stenosis who underwent DLDI from December 2019 to December 2021 at Tianjin Eye Hospital were considered for enrollment. The overall anatomic success rate was 84.8% for the entire cohort at the 2-year follow-up. In the multivariable model, a higher risk of failed DLDI surgery was associated with a history of chronic dacryocystitis (HR=3.07; P < 0.001) and a longer duration of epiphora than 1 year (HR=2.67; P < 0.001). Of the 522 patients, 37 patients (7.1%) had surgery-related complications. DLDI is an effective minimally invasive technique for treatment in patients with distal NLDO or stenosis. Factors associated with higher risk of reoperation include a longer duration of epiphora and a history of chronic dacryocystitis.