Success rate and factors affecting External Dacryocystorhinostomy outcome at Jimma university medical center department of ophthalmology 2016-2021 G.C

Abstract

Background Epiphora has been the most common presenting symptom in Nasolacrimal duct obstruction. Epiphora can cause socially undesirable effects with worsening vision-related quality-of-life, if untreated epiphora can develop into acute or chronic dacryocystitis. Dacryocystorhinostomy is a highly successful procedure in managing epiphora. The success of external DCR has been variably reported in the literatures. Objectives The purpose of the study is to present outcome of external DCR at Jimma university medical center, to assess factors that may influence surgical outcome, Method Hospital based, retrospective analytic study was conducted among patients who have undergone DCR 2016-2021 G.C. structured questionnaire used to collect data and collected data coded and entered into epidata and then exported to SPSS version 26 for statistical analysis. A multinomial logistic regression, Chi-square test and fishers exact test was performed P < 0.05 considered as statistically significant. Result A total of 105 patients were studied (mean age, 31.94 years), females to male ratio of nearly 3:1. The most frequent complaint was tearing (50%). Primary acquired NLDO (77 %) was most common presumed etiology of NLDO. Silicone intubation used in 75% of surgeries. Overall complete resolution of symptoms seen in 80% of cases. Success rate of external DCR with silicone intubation was much higher than DCR without tube (83.8% versus 69.2%, respectively, P=0.018). Retention of silicone longer than 3 month and post-operative wound site infection is associated with reduced success rate 71.6% and 55.6% respectively. Conclusion External DCR is a successful procedure and it is associated few complications. Silicone intubation improves surgical outcomes of external DCR But, Retention of silicone tube longer 3 month is associated with increased risk of failure Post-operative cellulitis may lead to a higher risk of failure in addition retention of silicone tube longer than 3 month is associated with statistically significant risk of postoperative cellulitis