Surgical outcomes of endoscopic dacryocystorhinostomy: analysis of 1083 consecutive cases

Objective: We report on the surgical outcome of endoscopic dacryocystorhinostomy (DCR) and analyze factors that influence surgical failure. Design: Retrospective observational cases series. Participants: A total of 1083 cases who underwent endoscopic DCR with bicanalicular lacrimal stent insertion, performed by 1 surgeon between January 2007 and February 2013. Methods: A retrospective chart review of 1083 cases who underwent endoscopic DCR with bicanalicular lacrimal stent insertion was performed, focusing on factors that were expected to affect the surgical outcomes. Surgical outcomes were recorded as the resolution of symptoms and endoscopic evidence of ostium patency postoperatively. Results: The overall success rate of DCR was 92.7% (1004 cases). Of 79 cases with unsuccessful outcomes, the visualization of anatomical obstruction with endoscopy was possible in 68 cases (86%), whereas no anatomic evidence of obstruction was found in 11 cases (14%). In total, 64 cases underwent additional lacrimal intervention, and 12 cases underwent revision surgery twice after the initial DCR operation. Radioactive iodine ablation was associated with surgery failure by logistic regression analysis. However, other factors, such as sex, age, the presence of earlier accidental tube removal, indications for surgery, and Guardix injection, did not show statistically significant differences. Conclusions: Endoscopic DCR is a surgical technique that has a predictable, favourable success rate. It could be considered appropriate for the initial treatment of nasolacrimal duct obstruction.