Clinical Evaluation Of Endoscopic Dacryocystorhinostomy Combined With Silicone Intubation For Chronic Dacryocystitis

Objective To investigate the efficacy of endoscopic dacryocystorhinostomy combined with silicone intubation in the treatment of chronic dacryocystitis.Methods A retrospective study was performed on patients with chronic dacryocystitis treated by endoscopic dacryocystorhinostomy combined with silicone intubation in the Ophthalmic Central Hospital of the Tujia and Miao Autonomous Prefecture Affiliated to Hubei Minzu University from April 2019through June 2021.The general information,medical history,symptoms,preoperative physical examination,imaging results,surgical procedure,and anatomical improvement of the patient were recorded,and analysed.Difference analysis of preoperative factors as the independengt risk factors for the success rate of the postoperative.The composition of the relevant factors is compared using the chi-square test.In the case of a small sample size,Fisher’s exact test was used for each individual parameter.The analysis of the metrological data was tested with an independent-samples T test.The test level α=0.05,P < 0.05 was considered statistically significant.Results A total of 173 cases（177 eyes）were recruited in this study,including 23males（23 eyes）and 150 females（154 eyes）,with an average age of 55.87±12.71 years old.155 eyes were chronic dacryocystitis,while 17 eyes recurrent chronic dacryocystitis,and 5 eyes presented with acute episodes of chronic dacryocystitis.All patients received endoscopic dacryocystorhinostomy combined with silicone intubation and at least 6 months of follow-up.168 eyes（94.92%）were cured,and 7eyes（3.95%）were improved while 2 eyes（1.13%）were ineffective,the effective rate was 98.97%.Postoperative complications include 9 eyes anastomotic closure,25 eyes granulation tissue formation and 5 eyes nasal adhesion.7 eyes with anastomotic closure improved after probing before extubation.There was no statistical significance between the silicone tube indwelling time and postoperative complications（P > 0.05）,All patients with recurrent dacryocystitis and acute episodes of chronic dacryocystitis were cured after endoscopic dacryocystorhinostomy combined with silicone intubation（15/15）.Univariate analysis showed that diabetes mellitus,nasosinusitis,and timely follow-up were correlated with the success rate of surgery（P = 0.023,P = 0.007,P = 0.044）.Whereas,there was no statistical significance in comparing sex,age,course of disease,rheumatism,etc.with the success rate of surgery（P > 0.05）.The operation time had no significant effect on the 72 hours complications after operation（P >0.05）.Conclusions Endoscopic dacryocystorhinostomy was of many advantages in the treatment of chronic dacryocystitis,such as high cured rate,no scar on the face,small trauma,etc.Silicone intubation provided a good lacrimal duct support environment for patients,anastomotic occlusion and contracture were effectively avoided.The advantages of Endoscopic dacryocystorhinostomy combined with silicone intubation treatment of chronic dacryocystitis have a higher cured rate and a better prognosis,and more conducive to postoperative follow-up and prevention of anastomotic closure.As diabetes mellitus and nasosinusitis were related to postoperative anastomotic closure,doctors should pay more attention to the cases with these diseases.