Dave Rashmi A, Rath Suryasnata, Tripathy Devjyoti, Mahapatra Samir, Ali Mohd Hasnat
Ophthalmic Plastic and Reconstructive Surgery Service, L.V. Prasad Eye Institute, Bhubaneswar, Odisha, India.
Clinical Epidemiology and Biostatistics, L.V. Prasad Eye Institute, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2025 Feb 1;73(2):244-248. doi: 10.4103/IJO.IJO_521_24. Epub 2024 Sep 19.
To compare the functional outcome and quality of life (QOL) index following non-endoscopic endonasal dacryocystorhinostomy (NEN-DCR) and external dacryocystorhinostomy (EXT-DCR).
Patients were prospectively allocated to two groups. All adult patients presenting with primary nasolacrimal duct obstruction (PANDO) undergoing EXT-DCR and NEN-DCR at a tertiary eye care center were included. Patients in one group underwent EXT-DCR and others NEN-DCR. Functional outcomes were measured by Munk Score and fluorescein dye disappearance test (FDDT). A validated quality of life questionnaire (EQ-5D-3L) in the local language (Odiya) was used to measure health status (social impact score) before and 1 day, 2 weeks, 6 weeks, and 3 months after surgery. The primary outcome measure was the functional outcome-Munk Score and secondary outcome measures included the QOL index and the FDDT.
A total of 110 patients were recruited and equally distributed ( n = 55) in both groups. The mean age of the population was 47.6 years (SD = 14.02; range 20-79 years). The majority (71%, 79/110) were female. When longitudinally followed over time, functional outcome and QOL index showed reasonably rapid and marked improvement in both groups after surgery compared to baseline scores. The Munk score ( P = 0.037) and QOL index ( P = 0.007) were marginally better on the first postoperative day for the NEN-DCR group compared to EXT-DCR but comparable at all subsequent visits. At a median follow-up of 9 weeks (range: 0.5-24 weeks), the anatomical outcome was comparable between both groups.
Our results demonstrate that functional outcome and QOL index show rapid and marked improvement in both NEN-DCR and EXT-DCR after surgery. NEN-DCR outcomes were marginally better on the first postoperative day but comparable to EXT-DCR thereafter.
比较非内镜下经鼻泪囊鼻腔造口术（NEN-DCR）和外路泪囊鼻腔造口术（EXT-DCR）后的功能结局和生活质量（QOL）指数。
前瞻性地将患者分为两组。纳入所有在三级眼科护理中心接受EXT-DCR和NEN-DCR治疗的原发性鼻泪管阻塞（PANDO）成年患者。一组患者接受EXT-DCR，另一组接受NEN-DCR。通过蒙克评分和荧光素染料消失试验（FDDT）测量功能结局。使用当地语言（奥迪亚语）的经过验证的生活质量问卷（EQ-5D-3L）在手术前以及术后1天、2周、6周和3个月测量健康状况（社会影响评分）。主要结局指标是功能结局——蒙克评分，次要结局指标包括QOL指数和FDDT。
共招募了110名患者，两组各55名。人群的平均年龄为47.6岁（标准差=14.02；范围20-79岁）。大多数（71%，79/110）为女性。随着时间的纵向随访，与基线评分相比，两组术后功能结局和QOL指数均显示出相当快速且显著的改善。与EXT-DCR相比，NEN-DCR组术后第一天的蒙克评分（P=0.037）和QOL指数（P=0.007）略好，但在所有后续随访中相当。在中位随访9周（范围：0.5-24周）时，两组的解剖学结局相当。
我们的结果表明，NEN-DCR和EXT-DCR术后功能结局和QOL指数均显示出快速且显著的改善。NEN-DCR术后第一天的结局略好，但此后与EXT-DCR相当。
