Evaluation of clinical efficacy of endoscopic endonasal dacryocystorhinostomy and postoperative peculiarities in patients with chronic dacryocystitis and type 2 diabetes mellitus

Authors

  • P.A. Bezditkov Kharkiv National Medical University, Kharkiv, Ukraine
  • N.M. Bezega Poltava State Medical University, Poltava, Ukraine

DOI:

https://doi.org/10.22141/2309-8147.10.1.2022.285

Keywords:

type 2 diabetes mellitus, chronic dacryocystitis, effectiveness of endoscopic endonasal dicryocystorhinostomy, postope­rative features, lacrimation

Abstract

Background. The study was aimed to evaluate the effectiveness of endoscopic endonasal dacryocystorhinostomy (EED) and to determine the postoperative features in patients with chronic dacryocystitis depending on the presence of type 2 diabetes mellitus (DM2). Materials and methods. The study included 30 DM2 patients with chronic dacryocystitis (basic group) and 30 nondiabetic patients with chronic dacryocystitis (control group), who underwent EED by the standard methods. Compensated DM2 (HbA1c < 7.1 %) was found in 6 patients of the basic group, subcompensated (HbA1c 7.1–7.5 %) — in 7 patients, decompensated (HbA1c > 7.5 %) — in 17 patients. The average age of patients in the basic group was 66.5 ± 9.5 years, in the control group — 66.3 ± 11.1 years. The results of the ope­ration were evaluated after 2, 6 months, and 2 years. EED was considered as an effective method of treatment in case of the restoration of free passive lacrimation during lavage of the lacrimal ducts, the disappearance of tearing in the patient and the absence of re-infection of the lacrimal sac. In addition to standard, ophthalmic examination methods included nasolacrimal duct probe, lacrimal absorption, and reflux test, lacrimal duct lavage, lacrimal duct probing, computed tomography, and endoscopic examination of the nasal cavity. Results. The efficiency of EED 2 months after surgery in patients of the basic group (70.0 ± 8.4 % of patients) was 1.3 times lower, after 6 months (63.3 ± 8.8 % of patients) — 1.4 times lower, and in recovery period for 2 years (50.0 ± 9.1 % of patients) — 1.6 times lower than in patients of the control group (p < 0.05). The analysis of the presence of the main symptoms of chronic dacryocystitis in the dynamics of observation demonstrated that after EED the most common symptom was tearing, but its frequency in patients of the basic group was higher by 4.5 times after 2 months (30.0 ± 8.4 % of patients), by 2.8 times — after 6 months (36.7 ± 8.8 % of patients), and 2.5 times — after 2 years (50.0 ± 9.1 % of patients) compared to patients of the control group (p < 0.05). Conclusions. In DM2 patients, the clinical effectiveness of EED in chronic dacryocystitis is lower than in nondiabetic patients, and the postoperative period has its own characteristics.

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Published

2022-05-17

Issue

Section

Clinical Ophthalmology