Multivariate Predictors of Dacryocystorhinostomy Failure: Beyond Surgical Techniques
Author: Abdulrahman Alfarhan
Base Hospital / Institution: Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital
ePoster presentation
Abstract ID: 24-414
Purpose
To uncover the intricate medical conditions, topical and systemic therapies associated with dacryocystorhinostomy failure in patients with acquired nasolacrimal duct obstruction
Methods
Retrospective review of patients who underwent dacryocystorhinostomy at a single centre between Jan 2017 and Dec 2022. Medical comorbidities, including diabetes mulitis, hypertension, thyroid dysfunction, rheumatologic diseases, history of current smoking, and history of sinus surgery were all recorded. Exposure to radiotherapy and the use of systemic therapies such as steroid and anticoagulation at the time of surgery was noted. Patients were divided into two groups—those with DCR failure and those succeed. Univariate and multivariate analysis was used to compare groups.
Results
587 patients underwent dacryocystorhinostomy over a six-year period. Failure was seen in 68 (11.6%) patients. Univariate analysis revealed a statistically significant difference between groups in rates of smoking, diabetes, and systemic steroid therapy at the time of surgery. Diabetes mulitis (P = 0.048; HR,1.7; 95% CI 1.004 – 2.944) and systemic steroid therapy (P = 0.001; HR,10.4; 95% CI 2.587 – 41.679) were independent predictors of exposure. Topical ocular antihypertensive treatments were not significantly associated with failure rates (P = 0.404). The crude probability of failure, independent of any risk factors, was 11.6%, with higher failure rates noted for endoscopic DCR compared to external DCR (15.8% vs. 9.7%, P = 0.034).
Conclusion
Topical ocular antihypertensive treatment were not assocaited with dacryocystorhinostomy failure. Diabetes mulitis and systemic steroid therapy were associated with failure in patient with aquired nasolacrimal duct obstruction. This study is pioneering in examining the role of medical comorbidities in dacryocystorhinostomy outcomes. Understanding these associations is crucial for preoperative planning and postoperative care, as it underscores the need for a thorough assessment of systemic health to enhance surgical success rates.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Osama | Alsheikh | Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital |
| Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital |
