Predictors of Surgical Success Following Endoscopic Dcr a Prospective Cohort Study
Keywords:
Endoscopic Dacryocystorhinostomy, Primary Acquired Nasolacrimal Duct Obstruction, Surgical Predictors, Epiphora, Lacrimal Drainage Obstruction, Surgical Outcome.Abstract
Background: Endoscopic dacryocystorhinostomy (DCR) has become the preferred surgical treatment for primary acquired nasolacrimal duct obstruction because of its high success rate and minimal morbidity. However, identifying factors that influence surgical outcomes remains essential for improving patient care.
Aims: To evaluate the predictors of surgical success following endoscopic DCR and determine the clinical and intraoperative factors associated with favorable postoperative outcomes.
Materials and Methods: This prospective cohort study was conducted in the Department of ENT, Sri Chamundeshwari Medical College Hospital and Research Institute, Channapatna, over a period of six months. Sixty patients with primary acquired nasolacrimal duct obstruction underwent endoscopic DCR. Demographic, clinical, intraoperative, and postoperative variables were recorded and analyzed using appropriate statistical tests.
Results: The overall surgical success rate was 90.0%. Advanced age, diabetes mellitus, chronic rhinosinusitis, and prolonged symptom duration were significantly associated with surgical failure (p<0.05). Adequate osteotomy, complete lacrimal sac exposure, and mucosal flap preservation significantly improved surgical success, while granulation tissue, synechiae, and rhinostomy restenosis were major predictors of failure.
Conclusion: Endoscopic DCR is a highly effective procedure with excellent outcomes. Careful patient selection, meticulous surgical technique, and appropriate postoperative follow-up significantly improve long-term anatomical and functional success.
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