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Long-term outcome of primary external dacryocystorhinostomy.

OBJECTIVE
To assess the long-term functional outcome of external dacryocystorhinostomy (DCR) in terms of epiphora.


STUDY DESIGN
Single-group cohort study.


PLACE AND DURATION OF STUDY
Section of Ophthalmology, The Aga Khan University Hospital, Karachi, from January 2000 to June 2010.


METHODOLOGY
This study included adults who underwent external DCR surgery at the AKUH during January 2000 to June 2010. The main outcome measure was the proportion of patients reporting to have developed epiphora after surgery. During the telephonic interviews participants were asked if they had a recurrence (symptoms such as watering or discharge) after surgery. Individuals answering in affirmative were asked when the symptoms started. Data on age at surgery, gender and pre-operative symptoms were collected from medical records. Recurrence-free curves were calculated according to the Kaplan-Meier method.


RESULTS
A total of 44 persons who underwent DCR surgery were contactable by telephone in 2011 and all agreed to participate in the study. The mean age of the patients at the time of surgery was 48.0 ± 15.8 years. Overall, 38.6% (17/44) participants reported having developed epiphora after surgery. The overall median recurrence-free time was 1.7 years; there was no statistically significant difference in the median recurrence-free time between men and women.


CONCLUSION
The long-term functional outcome of external DCR surgery does not appear to be optimal and, in fact, far worse than the short-term results reported in the international literature.