[Prognostic value of lacrimal duct diagnostics after tube removal : Retrospective analysis of risk of relapse during the first postoperative year after transcanalicular lacrimal duct surgery with silicone tubing].
BACKGROUND
Transcanalicular lacrimal duct surgery has become more important over the past two decades.


OBJECTIVE
The aim of the study was to prove the prognostic value of postoperative lacrimal syringing and the testing of spontaneous drainage of lacrimal fluid immediately after tube removal.


METHODS
A total of 110 cases with postoperative lacrimal syringing and 183 cases with verification of the postoperative lacrimal fluid drainage performed between January 2001 and August 2008 were retrospectively evaluated. The indication for postoperative diagnostics was set by the investigator. The prognostic value of these two procedures was determined by using prognostic parameters (positive predictive value, PPV; negative predictive value, NPV) and analyzing recurrence nonexistence via Cox regression and Kaplan-Meier estimator. The observation period was limited to 12 months. Predominantly, recurrence was defined on the patient's satisfaction and absence of symptoms, which was determined with the help of a questionnaire.


RESULTS
Postoperative verification of the lacrimal syringing is a suitable instrument to estimate surgical success within the first year after lacrimal surgery with a PPV of 92.31%. Testing of the spontaneous drainage of lacrimal fluid after tube removal reached a PPV of 63.33%.


CONCLUSIONS
The proven prognostic value shows that syringing of the lacrimal duct and verification of spontaneous drainage should be integrated into postoperative care in a standardized manner. Hereby, early information for the patient about the expected result of the surgical procedure is enabled.
Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland. fantila@web.de.
M
M
Böhm
Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland.
J
J
Heichel
Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland.
T
T
Bredehorn-Mayr
Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland.
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C
Lautenschläger
Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland.
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HG
Struck
D000328:Adult; D000368:Aged; D003608:Dacryocystorhinostomy / Q000706:statistics & numerical data*; D020878:Device Removal; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007440:Intubation / Q000295:instrumentation* / Q000706:statistics & numerical data*; D007767:Lacrimal Duct Obstruction / Q000175:diagnosis* / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012828:Silicones; D007507:Therapeutic Irrigation / Q000706:statistics & numerical data*; D016896:Treatment Outcome
D012828:Silicones
Lacrimal intubation; Lacrimal syringing; Spontaneous drainage of lacrimal fluid; Success rate; Transcanalicular lacrimal duct surgery