Preoperative Dacryo‐ <scp>CT</scp> Parameters as Predictors of Restenosis After Endoscopic <scp>DCR</scp>

ABSTRACT Objective To evaluate anatomical and structural parameters of the lacrimal sac and nasolacrimal duct system measured through dacryocystography with computed tomography (Dacryo‐CT) in relation to restenosis after endoscopic dacryocystorhinostomy (DCR) in a cohort of patients. Methods This retrospective study included patients undergoing endoscopic DCR with preoperative Dacryo‐CT imaging. Parameters analyzed included the dimensions of the lacrimal sac (vertical and horizontal axes), the thickness of the bone anterior to the lacrimal sac, the thickness of the sac walls, the ratio of nasolacrimal duct length to the extent of contrast medium descent, and the ratio of sac width to wall thickness. Restenosis was defined clinically and confirmed endoscopically within 18 months postoperatively. Multivariate logistic regression was performed to assess the association between Dacryo‐CT parameters and restenosis. Results Of 100 patients, restenosis occurred in 28 (28%). Restenosis was significantly associated with a reduced vertical axis of the lacrimal sac (mean, 7.8 vs. 10.2 mm, p &lt; 0.01) and increased sac wall thickness (mean, 1.5 vs. 1.2 mm, p = 0.02). A higher ratio of sac width to wall thickness correlated with a lower restenosis rate ( p = 0.04). The thickness of the anterior bone and the nasolacrimal duct length/contrast descent ratio showed no significant correlation with restenosis risk. Conclusion Preoperative Dacryo‐CT‐derived parameters, particularly lacrimal sac dimensions and wall thickness, may predict restenosis risk after endoscopic DCR. These findings highlight the importance of detailed anatomical evaluation to optimize surgical outcomes. Level of Evidence 3.