Anar ISMAYILZADA, Ibrahim Bulent BUTTANRI
Medical Science and Discovery - 2026;13(5):87-95
Objective: Primary acquired nasolacrimal duct obstruction (PANDO) is a common cause of epiphora in adults. External dacryocystorhinostomy (DCR) is considered the reference surgical treatment; however, the impact of prior dacryocystitis on surgical outcomes remains controversial. This study aimed to evaluate the impact of previous dacryocystitis on anatomical and functional outcomes after external DCR. Material and Methods: This retrospective cohort study included 574 eyes of 524 patients who underwent standardized external DCR between January 2011 and January 2016 at a tertiary referral center. Eyes were categorized into a study group with prior dacryocystitis (99 eyes, 17.2%) and a control group without prior infection (475 eyes, 82.8%). Surgical success was defined as anatomical patency confirmed by irrigation combined with functional success (Munk grades 0 -1). Functional outcomes were retrospectively assessed based on clinical records. Univariate and multivariable logistic regression analyses were performed. A reduced model was constructed to minimize overfitting, and a post -hoc power analysis was conducted. Results: The overall surgical success rate was 93.2% (535/574 eyes). Success was achieved in 96 eyes (97.0%) in the study group and 439 eyes (92.4%) in the control group, with no statistically significant difference between the groups (p=0.102). In multivariable analysis, prior dacryocystitis was not identified as an independent predictor of surgical failure (adjusted OR: 2.41; 95% CI: 0.68 -8.52; p=0.171). No significant associations were observed for age, sex, diabetes mellitus, hypertension, silicone tube use, or anesthesia type. The majority of anatomically successful cases corresponded to Munk grades 0 -1. The model demonstrated limited discriminative ability (AUC: 0.56). Post -hoc power analysis indicated a statistical power of 47.8%. Conclusion: External DCR provides high anatomical and functional success rates in patients with PANDO, regardless of prior dacryocystitis. When inflammation is adequately controlled before surgery, previous infection does not appear to adversely affect outcomes.
