Epidemiology of chronic dacryocystitis and success rate of external dacryocystorhinostomy in Nepal.
ABSTRACT To study the epidemiology of chronic dacryocystitis and the success rate of external dacryocystorhinostomy (DCR) in Nepal. Patients and
This is a retrospective descriptive and interventional case series. A total of 662 records of patients with chronic dacryocystitis due to nasolacrimal duct obstruction, who were treated by means of external DCR without bicanalicular silastic tube intubation, were studied.
Mean for age with standard deviation and confidence intervals were calculated. The significance of the difference in means was calculated using the unpaired t-test.
Of 662 patients, 67.6% were female. The mean age of the patients was 27.4 +/- 13.7 years (SE = 0.53, 95% CI = 26.34-28.46). Chronic dacryocystitis due to nasolacrimal duct obstruction was found in 86 patients (13.0%) from the high hills (mean age = 35.3 +/- 11.4 years, 95% CI = 32.85-37.75), but most patients (576, 87.0%) were from the subtropical lowlands with a monsoon climate (mean age = 26.9 +/- 13.3 years, 95% CI = 25.8-28.0; p = < 0.01). An overall success rate of 88.6% (89.8% for high-hill patients and 87.4% for those from the lowlands) was obtained after DCR.
Chronic dacryocystitis is more common in the subtropical plains of Nepal with a monsoon climate than in the high hills. It is predominantly found in pre-menopausal females. External DCR without bicanalicular silastic tube intubation is an effective method for treating chronic dacryocystitis due to NLDO in these patients.
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ABSTRACT: External dacryocystorhinostomy (DCR) is a surgical intervention aimed to treat blocked nasolacrimal ducts of almost all causes. To date there is only limited data available from the Sub Saharan African setting. This study aimed to provide further information of the outcomes of DCR in Africa. Records of all patients undergoing external DCR operations from January 2001 to April 2006 were systematically searched. 55 patients were identified and notes were available for 45 patients. Discharge and epiphora were resolved in 90.9% (30/33) and 84.4% (27/32) of patients respectively. Over half the cases (51.1%) were children. The commonest reason for operation was chronic dacryocystitis (51.1%). Outcomes for DCR were not significantly different for either children or adults and a clear improvement of symptoms was found in the vast majority of cases. This study provides information on the outcomes of DCR in the African population. An 84.4% cure rate of epiphora and 90.9% cure rate of discharge is comparable with findings in other developing countries. This study supports the continued use of this intervention in skilled hands for treatment of blocked nasolacrimal duct.African health sciences 06/2011; 11(2):252-4.
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ABSTRACT: ABSTRACT Purpose: Success rates for endoscopic and external dacryocystorhinostomy vary widely (external 70-95%; endonasal 59-99%). We investigated surgical preferences and reported success rates in dacryocystorhinostomy amongst American Society of Ophthalmic Plastic and Reconstructive Surgery members. Methods: This retrospective study utilized a questionnaire sent to American Society of Ophthalmic Plastic and Reconstructive Surgery members. Information culled included number of cases performed, surgical approach, and results. Results: 214 (38% response rate) surveys were completed, representing over 7,054 cases in one year. 93.9% of respondents offer external dacryocystorhinostomy; 63.1% offer endonasal. Surgeons report an increased rate of post-operative tearing with endonasal versus external (35.6% versus 5.8%, p < 0.001) and post-operative dacryocystitis with endonasal versus external (13.2% versus 1.0%, p < 0.001). The top reasons for choosing endoscopic DCR were patient preference, no visible scar, and prior failed DCR. The top reasons for choosing external DCR were higher success rate, physician preference, and more long-term data on outcome. The majority of members use bicanalicular Crawford tubes (76%). Tubes were most commonly removed during post-operative months 2 (34.6%) and 3 (36.4%). Conclusions: Despite papers reporting equivalent success rates between external and endonasal dacryocystorhinostomy, more American Society of Ophthalmic Plastic and Reconstructive Surgery members perform greater numbers of external dacryocystorhinostomy, prefer external dacryocystorhinostomy, and report a higher success rate with this approach.Orbit (Amsterdam, Netherlands) 02/2013; 32(1):20-6.
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ABSTRACT: Objective. To compare pre- and postoperative characteristics and surgical success rates of patients with and without previous episodes of dacryocystitis, who underwent external dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction (NLDO). Methods. The medical files of all patients who underwent external DCR between 2006 and 2011 in our institution were reviewed. The retrieved data of patients with and without previous episodes of dacryocystitis were compared. Surgical success was determined by postoperative followup of at least 6 months. Results. A total of 185 patients with NLDO underwent external DCR of whom 152 (100 females and 52 males, mean age 67 ± 15 years) met the inclusion criteria. Sixty had previous episodes of dacryocystitis and 92 did not. Left-side obstruction was more common than right-side obstruction among patients with previous episodes of dacryocystitis (48.3% versus 31.7%, resp., P = 0.031). Glaucoma patients were significantly more likely to develop dacryocystitis than patients without glaucoma (P = 0.002). The success rate of external DCR was 94.4% for patients with previous episodes of dacryocystitis and 86.7% for patients without (P = 0.337). Conclusions. The surgical outcomes of external DCR in patients with or without a previous episode of dacryocystitis were similar. Patients with glaucoma and NLDO had a significantly higher risk of developing dacryocystitis.Journal of Ophthalmology 01/2013; 2013:287524. · 1.37 Impact Factor