Association Between Race and Reoperation Following Dacryocystorhinostomy: A Multicenter Analysis
Author: Tehila Shlomov
Base Hospital / Institution: Department of Ophthalmology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
Rapid fire oral presentation
Abstract ID: 25-490
Purpose
The association between race and the risk of reoperation following dacryocystorhinostomy (DCR) remains unclear. This study evaluates whether racial differences influence the likelihood of reoperation after DCR in a large, multicenter analysis using real-world data.
Methods
Adults aged ≥18 years who underwent DCR between June 2005 and May 2025 were identified from the TriNetX Global Research Network using CPT, ICD-10-PCS, and SNOMED codes. Race – categorized as White, Asian, Black or African American, or Other – was the primary exposure. Each non-White group was compared to a 1:1 propensity score–matched (PSM) White cohort balanced for sociodemographic factors, comorbidities, and healthcare utilization. Patients with congenital lacrimal anomalies or lacrimal gland malignancy were excluded. Reoperation, defined as repeat DCR, was assessed over 10 years beginning 90 days after index surgery. Cox regression estimated hazard ratios (HRs), Kaplan–Meier curves illustrated cumulative incidence, and log-rank tests evaluated group differences. A sensitivity analysis excluded patients who died during follow-up.
Results
Following PSM, the Asian, Black or African American, and Other racial groups were each compared to matched White cohorts, comprising 1,820, 744, and 629 patients per group, respectively. Reoperation occurred in 255 Asian (14.0%) vs 190 White (10.4%) patients (HR, 1.32; 95% CI, 1.09–1.59; p=0.004), 83 Black (11.2%) vs 64 White (8.6%) patients (HR, 1.27; 95% CI, 0.92–1.76; p=0.153), and 75 Other (11.9%) vs 62 White (9.9%) patients (HR, 1.58; 95% CI, 1.13–2.22; p=0.007). Findings remained consistent in a sensitivity analysis excluding patients who died during follow-up.
Conclusion
Asian and Other racial groups exhibited significantly higher long-term reoperation risk following DCR compared with White patients, whereas no significant difference was observed for Black or African American patients. These findings highlight the need to investigate potential anatomical, procedural, or systemic contributors to these disparities.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Itay | Nitzan | Department of Ophthalmology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel |
| Ofira | Zloto | Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan, Israel |
| Zvi | Gur | Department of Ophthalmology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel |
