Endoscopic and external dacryocystorhinostomy show comparable outcomes
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KIAWAH ISLAND, S.C. — A study presented at Kiawah Eye found no difference in surgical outcomes between endoscopic and external dacryocystorhinostomy in adults and children with nasolacrimal duct obstruction.
The retrospective chart review included 20 children and 170 adults with a diagnosis of primary nasolacrimal duct obstruction or chronic dacryocystitis who underwent external or endoscopic dacryocystorhinostomy (DCR) in the last 10 years at one academic medical center.
“There was no difference between the two techniques in resolution of symptoms,” R. Bryce Robbins, MD, said. “There did tend to be a longer time to tube removal in the group that did have resolution of symptoms, but that difference was not statistically significant.”
The complication rate was comparable with the two techniques, but as expected, in patients who had complications, there was a lower chance of having resolution of symptoms postoperatively.
Smoking status, use of anticoagulants and diabetes did not seem to have a significant impact on surgical outcomes. A correlation was found between lower HbA1c and more resolution of symptoms, but the difference was not statistically significant.
“Looking at total operative time, the endoscopic DCR did take on average about 24 minutes longer than the external DCR, and that was statistically significant. But there was no difference between the two surgical techniques as far as need for revision postoperatively,” Robbins said.
There was no difference in the operative time on average between the pediatric and adult populations. A higher percentage of endoscopic procedures was performed in the pediatric group, but no differences were found in the complication rate and the need for revision between children and adults.
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Robbins RB, et al. Comparison of endoscopic versus external dacryocystorhinostomy in pediatric and adult populations. Presented at: Kiawah Eye; May 30-June 1, 2024; Kiawah Island, South Carolina.
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