The Agreement Between Syringing, Dacryocystography, and Dacryoendoscopy Findings in Lacrimal Duct Obstruction

Abstract Purpose: We retrospectively investigated the agreement of the diagnostic findings of syringing, dacryocystography (DCG), and dacryoendoscopy in the obstruction of the lacrimal drainage system (LDS). Methods: We examined 113 patients (211 LDS) who underwent syringing, DCG, and dacryoendoscopy for preoperative evaluation of LDS obstruction. Obstruction was compared by classifying the grade and the site of obstruction into three levels, respectively. The diagnostic agreement between the tests was assessed by determining the weighted Kappa value. Results: 25 male (49 LDS) and 88 female patients (162 LDS) were included in this study. LDS obstruction was observed in 77.4% of the cases by syringing, 60.0% by DCG, and 81.3% by dacryoendoscopy. Regarding the agreement in the obstruction grade, Cohen's Kappa value for DCG and dacryoendoscopy was 0.65 (95%CI: 0.56–0.74). Meanwhile, the DCG and dacryoendoscopy showed consistency in the site of obstruction in 77.9% of the cases. DCG found no obstruction in 38.4% of all cases, whereas 47.9% of them showed stenosis or obstruction by dacryoendoscopy. When discrepancies were observed between syringing and dacryoendoscopy to detect the site of obstruction, the combination of syringing and DCG reached the dacryoendoscopy findings at the 99% level. Conclusions: "Substantial" agreements were found between the diagnostic findings of the three examinations. Among them, the highest agreement was between syringing and dacryoendoscopy in determining the site of obstruction. The lowest agreements were between syringing and DCG in diagnosing the grade and the site of obstruction.