Factors Associated and Management of Functional Failure after External Dacryocystorhinostomy at Zonal Tertiary Hospital
Daniel Mashamba *
Kilimanjaro Christian Medical University College, P.O.Box 2240, Moshi, Tanzania.
Edwin Musheiguza
Kilimanjaro Christian Medical University College, P.O.Box 2240, Moshi, Tanzania.
William Makupa
Kilimanjaro Christian Medical University College, P.O.Box 2240, Moshi, Tanzania and Kilimanjaro Christian Medical Centre, P.O.Box 3010, Moshi, Tanzania.
*Author to whom correspondence should be addressed.
Abstract
Aims: To determine factors associated and management of functional failure after Dacryocystorhinostomy among patients attending the eye department at KCMC hospital Moshi Kilimanjaro, from January 2007 to July 2018.
Study Design: A retrospective cross-section hospital-based study.
Place and Duration of Study: Conducted at Eye Department Kilimanjaro Christian Medical Centre Hospital, between August 2018 and August 2019.
Methodology: We recruited 184 patients who underwent external DCR surgery from January 2007 to July 2018. The analysis was done using STATA version 14. Chi-square was used to establish the difference in proportions across groups, multivariable logistic regression models were used to determine the associated factors for functional failure. The 95% confidence intervals were constructed; associations were considered to be statistically significant when a P-value was less than 0.05.
Results: Out of 184 external DCR done, 37 (20.1%) had functional failure, 174 (94.6%) attained anatomical success while147 (79.9%) attained functional success. Fifty-one (27.4%) of cases had a primary function failure, of this 50% was managed by probing and irrigation. Functional failure was associated with postoperative complications (AOR=10.58 (95% CI: 2.24 - 49.88).
Conclusion: Functional failure after external Dacryocystorhinostomy was 20.1%, the anatomical success of external DCR was 94.6% and functional success was 79.9% in our study. The strongest associated factors for functional failure were a post-operative complication and increased age. Therefore, careful post-operative follow-up after DCR procedure should be emphasized to lacrimal surgeons. On the other hand, external DCR remains the surgical management options with good success.
Keywords: External Dacryocystorhinostomy, function success, function failure, anatomical success.