Prognostic factors for outcome of endoscopic dacryocystorhinostomy in patients with primary acquired nasolacrimal duct obstruction.

PURPOSE: To evaluate the prognostic factors for outcome of endoscopic dacryocystorhinostomy (DCR) in patients with primary acquired nasolacrimal duct obstruction.

MATERIALS AND METHODS: Eighty-three consecutive cases of endoscopic DCR performed for primary acquired nasolacrimal duct obstruction by a single surgeon were included in a retrospective, noncomparative case series. The outcome was assessed at a minimum of 5 months after surgery, being at least 3 months after removal of stents. Surgical success was defined both subjectively and objectively. Subjective success was defined as absence of epiphora. Objective anatomical success was defined as patency on syringing, and presence of a functioning rhinostomy evaluated using the functional endoscopic dye test. Variables assessed included age at surgery, gender, side, duration of intraoperative mitomycin C application, and duration of stent left in-situ. The prognostic factors for outcome were analyzed by the logistic regression test.

RESULTS: Of the 79 analyzed cases, 74 (93.7%) had successful surgical outcomes. The mean age at time of surgery was 55.5 ± 13.3 years, and the majority of patients were female (85%). The mean follow-up period was 23.3 ± 16.8 months. Age at surgery is a significant factor influencing the surgical outcome (P < 0.05). Gender, side, duration of intraoperative mitomycin C application, and duration of stent left in-situ had no significant association with the outcome (P > 0.05).

CONCLUSION: In endoscopic DCR for primary acquired nasolacrimal duct obstruction, younger patient age at time of surgery was associated with a higher rate of failure.