Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, Telangana, India.
Mumbai Eye Plastic Surgery, Mumbai, Maharashtra, India.
Eur J Ophthalmol. 2022 Jan;32(1):129-133. doi: 10.1177/1120672121994747. Epub 2021 Feb 12.
The objective of this study is to propose a simple grading to assess the health of a dacryocystorhinostomy (DCR) ostium.
Prospective case series of 237 Ostia evaluated following dacryocystorhinostomy were included in the study. All the ostia were assessed for 10 parameters in detail using the earlier published DCR ostium scoring (DOS scoring). Each of the 10 parameters were scored individually, and final DOS scores were obtained. The anatomical and functional outcomes of each of the surgery were noted. The most significant parameters that influenced the success were determined using the binary recursive partitioning in a conditional inference framework. Data management and statistical tests were performed using the statistical "Software R" and the library "partykit" toolkits.
The most significant DCR ostium parameters that influenced the outcomes were anatomical and functional fluorescein dye transit ( < 0.001), dynamicity of internal common opening (ICO) on the blink ( < 0.001), end-on threats to ICO from granuloma, membrane or a synechia, and cicatricial closure of the Ostia. Each of these significant factors (FICI - Fluorescein endoscopy dye test, ICO dynamicity, Cicatricial ostium closure and ICO threats) were assigned simple scoring and the final scores were graded from 0 (poor DCR ostium) to +5 (excellent DCR ostium). FICI grading can guide the physician on the health status of the DCR ostium and the possible need for intervention.
FICI DCR ostium grading is a simple, easy to perform, and physician-friendly system. More studies with larger sample size would help in further validating the FICI grading.
本研究旨在提出一种简单的评分系统，以评估泪囊鼻腔吻合术（DCR）造口的健康状况。
前瞻性纳入 237 例 DCR 术后造口的病例系列研究。使用先前发表的 DCR 造口评分（DOS 评分）对所有造口进行详细评估，共 10 个参数。对 10 个参数进行单独评分，获得最终的 DOS 评分。记录每个手术的解剖学和功能结果。使用条件推断框架中的二元递归分区确定影响成功的最重要参数。使用统计“R 软件”和“partykit”工具包进行数据管理和统计检验。
影响结果的最重要的 DCR 造口参数是解剖学和功能荧光素染料通过（ < 0.001）、眨眼时内部共同开口（ICO）的动态性（ < 0.001）、肉芽肿、膜或粘连对内 ICO 的直接威胁，以及造口的瘢痕性闭合。这些重要因素中的每一个（FICI-荧光素内镜染料试验、ICO 动态性、造口瘢痕性闭合和 ICO 威胁）都被赋予了简单的评分，最终评分从 0（DCR 造口差）到+5（DCR 造口优）。FICI DCR 造口评分是一种简单、易于操作且便于医生使用的系统。更大样本量的研究将有助于进一步验证 FICI 评分。
