Efficacy of Modified Endoscopic Dacryocystorhinostomy in the Treatment of Chronic Dacryocystitis

Abstract

Background: Untreated chronic dacryocystitis (CD) can lead to serious ocular complications. Objectives: This study aimed to analyze the efficacy of modified endoscopic dacryocystorhinostomy (DCR) in the treatment of CD and the effects on ocular surface, inflammatory response, and immune function of patients. Methods: A retrospective cohort study was conducted to examine the clinical data of 110 patients (110 eyes) with CD who visited The First People's Hospital of Wenling, China, from July 2018 to February 2021, and they were divided into a conventional group (62 patients and 62 eyes underwent conventional DCR) and modified group (48 patients and 48 eyes received modified endoscopic DCR). The perioperative indexes, efficacy, and complications of the two groups were compared, and the changes in ocular surface, inflammatory response, and immune function of the patients before and 3 months after the surgery were observed. Results: The intraoperative bleeding, hospitalization cost, and 12-h postoperative visual analogue scale (VAS) score were lower, while the operative time and hospitalization time were shorter in modified group than in the conventional group (P<0.05). The total treatment efficacy was higher (91.67%) in the modified group than in the conventional group (72.58%), and the recurrence rate was lower in the modified group (4.17%) than in the conventional group [16.13%, P<0.05]. The ocular surface symptom scores, Schirmer I test, tear break-up time, degree of tear overflow scores were lower in the modified group than in the conventional group at 3 months postoperatively (P<0.05); soluble interleukin-1β, interleukin-6, high-sensitivity C-reactive protein, CD8+ levels were lower, and CD3+, CD4+, CD4+/CD8+ levels were higher in the modified group than in the conventional group at 3 months postoperatively (P<0.05). At 3 months postoperatively, the scores of activity impairment, general health, and visual status on the National Eye Institute 25-Item Visual Function Questionnaire were higher in the modified group than those in the conventional group (P<0.05). The overall complication rate in the modified group (8.33%) was not different from that in the conventional group [14.52%, P>0.05]. Conclusion: Modified DCR has the advantages of short operation time, less trauma, less pain and fewer complications, and is conducive to improving ocular surface function, reducing inflammatory response, and improving immune function and quality of life of patients.