Comparing outcomes of pediatric and adult external dacryocystorhinostomy in Nepal: Is age a prognostic factor?

Autor: Limbu B; a Department of Ophthalmology , Tilgnanga Institute of Ophthalmology , Kathmandu , Nepal., Katwal S; b Department of Ophthalmology , Rapti Eye Hospital , Dang , Nepal., Lim NS; c Department of Ophthalmology , Prince of Wales Hospital , Sydney , Australia., Faierman ML; d College of Medicine , Ohio State University , Columbus , Ohio , USA., Gushchin AG; e Moran Eye Center , University of Utah Health Center , Salt Lake City , Utah , USA., Saiju R; a Department of Ophthalmology , Tilgnanga Institute of Ophthalmology , Kathmandu , Nepal.
Jazyk: angličtina
Zdroj: Orbit (Amsterdam, Netherlands) [Orbit] 2017 Aug; Vol. 36 (4), pp. 237-242. Date of Electronic Publication: 2017 Mar 31.
DOI: 10.1080/01676830.2017.1287743
Abstrakt: We determine whether age is a prognostic factor for surgical outcomes of external dacryocystorhinostomy (Ex-DCR). This retrospective cohort study conducted at Tilganga Institute of Ophthalmology (Kathmandu, Nepal) compared pediatric Ex-DCR procedures (age ≤ 15 years) to adult Ex-DCR procedures (age > 15 years) and was performed between January 2013 and December 2013, with a minimum follow-up period of 6 months. Primary outcome measure was rate of success, defined as complete resolution of subjective symptom(s) of epiphora (subjective success), combined with patent lacrimal passage on syringing (anatomical success) at last follow-up visit. Other outcome measures included clinical presentation, diagnosis, intraoperative complications and post-operative complications. In total, 154 Ex-DCR procedures were included, with an age range of 8 months to 81 years (mean age 36.4 ± 21.0 years). In all, 38 pediatric Ex-DCR procedures were compared to 116 adult procedures. Success rates were 97% in the pediatric group and 95% in the adult group, with no clinically or statistically significant difference in success rate or complication rate between groups (p > 0.05). Our study yielded high success rates of Ex-DCR in both pediatric and adult age groups suggesting that Ex-DCR remains an optimal treatment choice for all age groups. With no difference in surgical outcomes between pediatric and adult patients, including complication rate, we conclude that age is not a prognostic factor for Ex-DCR failure. We do not recommend adjuvant therapy for pediatric patients.
Databáze: MEDLINE
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