Long-Term Results of Primary and Revision Endoscopic Dacryocystorhinostomy at a Single Institution

Objective: The treatment of nasolacrimal canal obstruction through endoscopic DCR is both e!ective and safe. Our study aims to assess the preoperative factors in"uencing the success of endoscopic dacryocystorhinostomy. Methods: We conducted a retrospective review of all consecutive endoscopic DCR procedures performed over a 5-year period from 2019 to 2024. All patients underwent a minimum 6-month follow-up after stent removal. Patient records were examined for demographic details, previous surgical procedures, reasons for failure, clinical and surgical characteristics, adjunctive procedures, and success rates at the final follow-up. Results: Endoscopic dacryocystorhinostomy (eDCR) was performed on a total of 58 patients, with a mean follow-up period of 31.88 ± 15.79 months (range, 6-60). Upon further examination of comorbid disease subtypes, a statistically significant relationship was observed between the presence of autoimmune diseases (Hashimoto’s thyroiditis, Graves’ disease, ankylosing spondylitis, psoriasis) and the likelihood of undergoing revision surgery (P=.005). Of the revision endo-DCR group, 9 (75%) patients underwent concurrent endonasal surgery during their revision operation. Septoplasty was performed in 2 (16.6%) cases, and concha bullosa surgery was performed in 7 (58.4%) cases. A statistically significant difference was observed among the concurrent surgeries, particularly in terms of concha bullosa surgery (P=.001). Conclusion: Understanding the factors correlated with endo-DCR failure can inform preoperative counseling and refine intraoperative surgical approaches for patients undergoing treatment for nasolacrimal canal obstruction.