Long-Term Outcomes of External Dacryocystorhinostomy in the Age of Transcanalicular Microendoscopic Techniques

Abstract

Purpose. This study aimed to evaluate long-term results of external dacryocystorhinostomy (DCR) at a tertiary eye care center specializing in lacrimal duct surgery in Germany. Methods. The medical records of 1010 patients with acquired nasolacrimal duct obstruction (NLDO), who had undergone lacrimal duct surgery at a tertiary eye care center, were reviewed. Only adult patients who had undergone external DCR were included. The evaluation included the following parameters: age, gender, duration of symptoms, patient satisfaction, previous dacryocystitis, complication rates, and surgical outcome. Results. 154 eyes of 146 patients (14.5%) could be included in the study. The average age was 64.1 ± 29.7 years. 66.4% of patients were females and 33.6% were males. Acute or chronic dacryocystitis was found in 81 patients (55.5%). Overall, 82.8% of patients had full resolution of symptoms. The success rate of external DCR for patients with previous episodes of dacryocystitis was 82.7% compared to 83.4% for patients without dacryocystitis in their medical history. Conclusion. In cases in which transcanalicular microendoscopic techniques are contraindicated (e.g., after dacryocystitis) or in complex cases where microendoscopic procedures have failed (revision surgery), external DCR is still the surgical treatment of choice with very good postoperative success.

Characteristics and Surgical Outcomes of Patients Undergoing Dacryocystorhinostomy in Kashmir

“…This is similar to study conducted by M. Alnawaiseh et al, 2 in which patients with previous episodes of dacryocystitis had a success rate of 82.7% and those without previous episodes of dacryocystitis reported a success rate of 83.4%. Gilad et al 8 observed 94.4% success rate in patients with dacryocystitis and 86.7% in patients without such history ( = 0.337).…”

“…16,17 However, external DCR is a cost effective and equally efficacious procedure with similar success rates and is preferable in cases where endoscopic procedures are contraindicated and in previous failed surgeries. 2 In conclusion external DCR still remains the treatment of choice for NLDO in our setup with very good postoperative results in patients with or without previous history of dacryocystitis.…”

“…Advantages over external DCR include the lack of a skin incision, shorter operating time, minimal blood loss and less risk of cerebrospinal fluid leakage. 2,3 However, success rates of both the procedures are almost similar and may range from 63% to 97%. 4 Factors such as surgical variability, patient demographics and lack of standardised outcomes in literature may be responsible for the wide range of success rates.…”

“…after dacryocystitis) or in failed cases requiring revision surgery. 2 Various studies conducted have shown that surgical success co-relates with factors like patient age, duration of obstruction and presence or absence of previous episodes of dacryocystitis. 6,7,8 The aim of this study was to evaluate the pre-and postoperative characteristics and surgical outcomes in patients who underwent DCR in our tertiary care centre.…”

Comparison of Anatomical and Symptomatic Success in Transcanalicular Laser Dacryocystorhinostomy

“…5 These procedures preserve the physiology of the lacrimal duct system and are a viable alternative to external procedures. 6 The advantages of endoscopic dacryocystorhinostomy over EX-DCR are better hemostasis, lack of scarring, shorter operating time and protection of the lacrimal pump mechanism.…”