Factors Associated and Management of Functional Failure after External Dacryocystorhinostomy at Zonal Tertiary Hospital

Main Article Content

Daniel Mashamba
Edwin Musheiguza
William Makupa

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.

Article Details

How to Cite
Mashamba, D., Musheiguza, E., & Makupa, W. (2020). Factors Associated and Management of Functional Failure after External Dacryocystorhinostomy at Zonal Tertiary Hospital. Ophthalmology Research: An International Journal, 13(2), 44-53. https://doi.org/10.9734/or/2020/v13i230165
Section
Original Research Article

References

Ali M, Naik M, Honavar S. External dacryocystorhinostomy: Tips and tricks. Oman Journal of Ophthalmology. 2012;5(3):191.

Kashkouli MB, Mirzajani H, Jamshidian-Tehrani M, Shahrzad S, Sanjari MS. Fluoresce in dye disappearance test. Ophthalmic Plastic and Reconstructive Surgery. 2015;31(4):296–299.

Ali S, Rizvi R, Sharma SC. Management of traumatic dacryocystitis and failed dacryocystorhinostomy using silicone lacrimal intubation set. 2011;63:264–268.

Alnawaiseh M, Mihailovic N, Wieneke AC, Prokosch V, Rosentreter A, Merté RL, Eter N. Long-term outcomes of external dacryocystorhinostomy in the age of transcanalicular microendoscopic techniques. Journal of Ophthalmology. 2016;1:1–5.

Lee MJ, Khwarg SI, Choung H, Kim N. Associated factors of functional failure of external dacryocystorhinostomy. Canadian Journal of Ophthalmology/Journal Canadien d’ophtalmologie. 2014;49(1):40–44.

Lee MJ, Khwarg SI, Kim IH, Choi JH, Choi YJ, Kim N, Choung HK. Surgical outcomes of external dacryocystorhinostomy and risk factors for functional failure: A 10-year experience. Eye (Basingstoke). 2017; 31(5):691–697.

Lefebvre DR, Dhar S, Lee I, Allard F, Freitag SK. External dacryocystorhinostomy outcomes in patients with a history of dacryocystitis. Digital Journal of Ophthalmology: DJO. 2015;21(3):1–22.

Badhu BP, Dulal S, Kumar S, Thakur SKD, Sood A, Das H. Epidemiology of chronic dacryocystitis and success rate of external dacryocystorhinostomy in Nepal. Orbit. 2005;24(2):79–82.

Nemet AY, Fung A, Martin PA, Benger R, Kourt G, Danks JJ, Tong JC. Lacrimal drainage obstruction and dacryocystorhinostomy in children. Eye. 2008;22(7):918–924.

Barmettler A, Erlich J, Lelli G. Current preferences and reported success rates in dacryocystorhinostomy amongst ASOPRS members. Orbit (Amsterdam, Netherlands). Use the "Insert Citation" button to add citations to this document. 2013;32(1):20–26.

Bowling B. Kanski’s clinical ophthalmology: A systematic approach. In 8th Ed. New South Wales: Elsevier Limited. 2016;71–75.

dos Santos Martins TG, de Azevedo Costa ALF, Centelhas AC, dos Santos Martins DG. Use of biodegradable collagen-glycosaminoglycan copolymer matrix implant to reduce postoperative fibrosis in strabismus surgery. Taiwan J Ophthalmol. 2017;7(4):227–229.

Elmorsy SM, Fayk HM. Nasal endoscopic assessment of failure after external dacryocystorhinostomy. Orbit. 2010;29(4): 197–201.

Emmerich K. Modern lacrimal duct surgery from the ophthalmological perspective. 2010;107(14):254–258.

Erdöl H, Akyol N, Imamoglu HI, Sözen E. Long-term follow-up of external dacryocystorhinostomy and the factors affecting its success. Orbit. 2005;24(2):99–102.

Fayers T, Laverde T, Tay E, Olver JM. Lacrimal surgery success after external dacryocystorhinostomy: Functional and anatomical results using strict outcome criteria. Ophthalmic Plastic and Reconstructive Surgery. 2009;25(6):472–475.

Frimmel S, Zandi S, Sun D, Zhang Z. Original article molecular imaging of retinal endothelial injury in diabetic animals. Journal of Ophthalmic & Vision Research. 2017;12(4):419–423.

Ghasemi H, Asl SA, Yarmohammadi ME. External dacryocystorhinostomy; Success rate and causes of failure in endoscopic and pathologic evaluations. 2017;12(3): 189–194.

Heena Kubravi S, Tariq Qureshi S, Akbar E, Nawaz S, Kawoosa K. Characteristics and surgical outcomes of patients undergoing dacryocystorhinostomy in Kashmir. Journal of Evolution of Medical and Dental Sciences. 2017;5(93):6879–6882.

Li G, Guo J, Liu R, Hu W, Xu L, Wang J, Cai S, Zhang H, Zhu Y. Lacrimal duct occlusion is associated with infectious keratitis. International Journal of Medical Sciences. 2016;13(10):800–805.

Loon SC. Review Primary external dacryocystorhinostomy versus primary endonasal dacryocystorhinostomy. 2010;418–426.

Mekonnen W, Adamu Y. The outcome of external dacryocystorhinostomy in Ethiopian patients. Ethiop Med J. 2009;47(3):221–226.

Jan S, Wani JS, Riaz R, Nazir O. Evaluation of dacryocystorhinostomy failure with computed tomographic dacryocystography. 2017;5(12):5197–5202.

Katre P, Harkare V. Epidemiological study of dacryocystitis in rural population. 2017;7(1):11–14.

Konuk O, Kurtulmusoglu M, Knatova Z, Unal M. Unsuccessful lacrimal surgery: Causative factors and results of surgical management in a tertiary referral center. Ophthalmologica. 2010;224(6):361–366.

Paik JS, Cho WK, Yang SW. Comparison of endoscopic revision for failed primary external versus endoscopic dacryocystorhinostomy. Clinical and Experimental Ophthalmology. 2013;41(2): 116–121.

Lee JJ, Lee HM, Lim HB, Seo SW, Ahn HB, Lee SB. Learning curve for endoscopic endonasal Dacryocystorhinostomy. Korean Journal of Ophthalmology: KJO. 2017;31(4):299– 305.

Moscato EE., Dolmetsch AM, Silkiss RZ, Seiff SR. Silicone intubation for the treatment of epiphora in adults with presumed functional nasolacrimal duct obstruction. Ophthalmic Plastic, and Reconstructive Surgery. 2012;28(1):35– 39.