Critical factors for successful outcomes of endoscopic dacryocystrhinostomy.

OBJECTIVES This study aimed to investigate the factors that influence successful outcomes of endoscopic dacryocystorhinostomy (En-DCR), such as patency of the newly created ostium and lacrimal symptom improvement.

METHODS This retrospective, single-center study evaluated the medical records of individuals who underwent En-DCR at our institution between 2012 and 2023. A successful outcome was defined as both symptomatic improvement and patency of the newly created ostium at the last visit. The clinical factors influencing the outcome were analyzed using univariate and multivariate Cox proportional hazards regression analyses.

RESULTS This study evaluated 155 patients (age [mean ± SD] 69.2 ± 14.1 years; 113 women, 42 men, and 239 sides). Symptomatic improvement and a newly created ostium were observed in 181 sides (75.7 %). In multivariate analyses, the significant factors associated with successful En-DCR outcomes were placement of a silicone stent (hazard ratio [HR], 1.67; p = 0.0017), identification of a lacrimal puncta on the lateral wall of the lacrimal sac with an endoscope (HR, 1.96; p < 0.001), and perioperative use of a lacrimal duct endoscope (HR, 2.03; p = 0.0011).

CONCLUSIONS The critical factors influencing successful outcomes of En-DCR were the placement of a silicone stent, identification of the lacrimal puncta on the lateral wall of the lacrimal sac, and active use of a lacrimal duct endoscope. These findings may contribute to improving the success rate of En-DCR.