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Symptom assessment in patients with functional and primary acquired nasolacrimal duct obstruction before and after successful dacryocystorhinostomy surgery: a prospective study.
  1. Leanne M Cheung (drleannecheung{at}gmail.com),
  2. Ian C Francis (iancfrancis{at}gmail.com),
  3. Fiona Stapleton (f.stapleton{at}visioncrc.org),
  4. Geoffrey A Wilcsek (gwilcsek{at}bigpond.com)
  1. Prince of Wales Hospital, Australia
  2. Prince of Wales Hospital, Australia
  3. School of Optometry and Vision Science UNSW, Australia
  4. Prince of Wales Hospital, Australia

    Abstract

    Aim: To evaluate symptoms in patients with functional (FNLDO) and primary acquired (PANDO) nasolacrimal duct obstruction, evaluated prospectively before and after successful dacryocystorhinostomy (DCR) surgery.

    Design: A questionnaire delivered by interview, pre- and post-intervention.

    Methods: Consecutive patients with either FNLDO or PANDO were derived from a tertiary referral clinic and private practice of two surgeons (GW and ICF). The preoperative cohort consisted of 33 FNLDO patients and 28 PANDO patients. Of these only 31 patients elected to proceed to dacryocystorhinostomy (DCR) surgery. There were 12 FLNDO patients and 19 PANDO patients in the postoperative cohorts, all with definitive surgical success. Successful DCR surgery was indicated by positive endoscopic Jones 1 testing. Symptoms in relation to the patient's vision, reading, driving, mood, work and embarrassment were assessed. The severity of these symptoms was also graded.

    Results: Vision and reading in particular were affected in both preoperative cohorts, and patients sufferred significantly from embarrassment. Of the postoperative cohorts, the FNLDO cohort had a reduced percentage of patients suffering each symptom type, whereas the PANDO group had a reduction in percentage of patients reporting each symptom in some but not all areas. However the overall severity was reduced in both groups and embarrassment was significantly reduced in both groups.

    Conclusion: In both FNLDO and PANDO populations, symptoms bother patients significantly, and successful DCR surgery has a positive effect on the patient's physical and psychological well being.

    • dacryocystorhinostomy
    • epiphora
    • nasolacrimal duct obstruction, ,

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