Clinical outcomes and prognostic factors in patients with nasolacrimal duct obstruction or stenosis using dacryoendoscopy.

Autor:	Li H; Department of Orbital and Oculoplastic Surgery, Tianjin Eye Hospital, Tianjin, China.; Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin, China., Li J; Department of Orbital and Oculoplastic Surgery, Tianjin Eye Hospital, Tianjin, China., Zhang L; Department of Orbital and Oculoplastic Surgery, Tianjin Eye Hospital, Tianjin, China.; Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin, China., Yang L; Department of Orbital and Oculoplastic Surgery, Tianjin Eye Hospital, Tianjin, China., Zhao Y; Department of Orbital and Oculoplastic Surgery, Tianjin Eye Hospital, Tianjin, China., Zhao H; Department of Orbital and Oculoplastic Surgery, Tianjin Eye Hospital, Tianjin, China., Pan Y; Department of Orbital and Oculoplastic Surgery, Tianjin Eye Hospital, Tianjin, China panye6521@163.com.
Jazyk:	angličtina
Zdroj:	BMJ open ophthalmology [BMJ Open Ophthalmol] 2024 Oct 31; Vol. 9 (1). Date of Electronic Publication: 2024 Oct 31.
DOI:	10.1136/bmjophth-2024-001743
Abstrakt:	Objective: To evaluate the effectiveness of dacryoendoscopic-assisted laser dacryoplasty with silicone intubation (DLDI) for the management of nasolacrimal duct obstruction (NLDO) or stenosis, and to identify the factors associated with DLDI failure. Methods and Analysis: This study was designed as a prospective, single-centre cohort study. Patients with NLDO or stenosis who underwent DLDI from December 2019 to December 2021 at Tianjin Eye Hospital were considered for enrolment. The Kaplan-Meier estimator was used to assess the anatomical and functional success rate of DLDI within 2 years follow-up after removal of the silicone stent. Cox proportional hazards regression models were used to identify risk factors for treatment failure. Results: 170, 174 and 178 eyes were included in Groups A (proximal NLDO), B (distal NLDO) and C (nasolacrimal duct stenosis), respectively. The overall anatomical success rate was 84.8% for the entire cohort at the 2-year follow-up. The cumulative anatomical or functional success rate for Groups B and C was significantly higher than that for Group A. In the multivariable model, a higher risk of failed DLDI surgery was associated with a history of chronic dacryocystitis (HR=3.07; p<0.001) and a longer duration of epiphora than 1 year (HR=2.67; p<0.001). Of the 522 eyes, 37 patients (7.1%) had surgery-related complications. Conclusions: DLDI is an effective minimally invasive technique for treatment in patients with distal NLDO or stenosis. Factors associated with a higher risk of reoperation include a longer duration of epiphora and a history of chronic dacryocystitis. Trial Registration Number: NCT05999058. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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