Department of Ophthalmology, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong SAR, People's Republic of China.
Graefes Arch Clin Exp Ophthalmol. 2013 May;251(5):1361-7. doi: 10.1007/s00417-012-2228-9. Epub 2012 Dec 19.
To evaluate the prognostic factors for outcome of endoscopic dacryocystorhinostomy (DCR) in patients with primary acquired nasolacrimal duct obstruction.
Eighty-three consecutive cases of endoscopic DCR performed for primary acquired nasolacrimal duct obstruction by a single surgeon were included in a retrospective, noncomparative case series. The outcome was assessed at a minimum of 5 months after surgery, being at least 3 months after removal of stents. Surgical success was defined both subjectively and objectively. Subjective success was defined as absence of epiphora. Objective anatomical success was defined as patency on syringing, and presence of a functioning rhinostomy evaluated using the functional endoscopic dye test. Variables assessed included age at surgery, gender, side, duration of intraoperative mitomycin C application, and duration of stent left in-situ. The prognostic factors for outcome were analyzed by the logistic regression test.
Of the 79 analyzed cases, 74 (93.7%) had successful surgical outcomes. The mean age at time of surgery was 55.5 ± 13.3 years, and the majority of patients were female (85%). The mean follow-up period was 23.3 ± 16.8 months. Age at surgery is a significant factor influencing the surgical outcome (P < 0.05). Gender, side, duration of intraoperative mitomycin C application, and duration of stent left in-situ had no significant association with the outcome (P > 0.05).
In endoscopic DCR for primary acquired nasolacrimal duct obstruction, younger patient age at time of surgery was associated with a higher rate of failure.
评估原发性获得性鼻泪管阻塞患者行内镜鼻内泪囊鼻腔吻合术（DCR）结局的预测因素。
回顾性非对照病例系列研究纳入了 83 例由同一位外科医生进行的内镜 DCR 治疗原发性获得性鼻泪管阻塞的连续病例。术后至少 5 个月（支架取出后至少 3 个月）进行结果评估。手术成功的评估包括主观和客观标准。主观成功定义为无溢泪。客观解剖学成功定义为冲洗通畅，以及使用功能性内镜染料测试评估存在功能鼻内造口。评估的变量包括手术时的年龄、性别、侧别、术中丝裂霉素 C 应用时间和支架留置时间。采用逻辑回归检验分析结果的预测因素。
在 79 例可分析的病例中，74 例（93.7%）手术结果成功。手术时的平均年龄为 55.5±13.3 岁，大多数患者为女性（85%）。平均随访时间为 23.3±16.8 个月。手术时的年龄是影响手术结果的重要因素（P<0.05）。性别、侧别、术中丝裂霉素 C 应用时间和支架留置时间与结果无显著相关性（P>0.05）。
在原发性获得性鼻泪管阻塞的内镜 DCR 中，手术时的年龄越小，失败率越高。
