Improvement of Chronic Epiphora Symptoms after Surgery in Patients with Different Preoperative Schirmer-Test Values

Zusammenfassung

Hintergrund: Vergleich der Epiphora-Symptomverbesserung nach Operation von Patienten mit unterschiedlichen präoperativen basalen Schirmer-Test-Werten. Patienten und Methode: Design: Retrospektive, vergleichende Fallserie-Studie. Teilnehmer: 22 konsekutive Patienten (ein Auge/Patient) mit chirurgischer Therapie aufgrund chronischer, therapieresistenter Epiphora. Einteilung in 2 Gruppen anhand der präoperativen basalen Schirmer-Test-Werte (Oxybuprocain-HCl 0,4 %): Gruppe I: 0 – 6 mm (n = 11), Gruppe II: 7 – 25 mm (n = 11). Eingriff: Kombination von Piffarettis transpunktaler endoskopischer lacrimaler Drainage (n = 22), lacrimaler Intubation (n = 8), lacrimaler Punktoplastik (n = 22), lateraler Kanthoplastik (n = 18) und/oder Konjunktivochalasis-Chirurgie (n = 8). Outcome: Subjektive Symptomverbesserung der Epiphora 1 Jahr postoperativ. Ergebnisse: Während die mittleren (± SD) präoperativen basalen Schirmer-Test-Werte zwischen Gruppe I und II signifikant unterschiedlich waren (4 ± 3 mm vs. 10 ± 6 mm, p ≤ 0.001, Mann-Whitney-Test), zeigte die postoperative Epiphora-Symptomverbesserung keinen signifikanten Unterschied (82 % ± 30 % vs. 76 % ± 34 %, p = 0,92). Die Korrelation von Schirmer-Test-Werten und Symptomverbesserung war nicht signifikant (rho = -0,11, p = 0,62, Spearman-Koeffizient). In beiden Gruppen berichteten > 70 % der Patienten über eine ≥ 70 % (zufriedenstellende) Symptomverbesserung. Schlussfolgerung: In dieser Studie zeigten Patienten mit unterschiedlichen basalen Schirmer-Test-Werten eine ähnliche Epiphora-Symptomverbesserung ein Jahr postoperativ.

Abstract

Background: To compare improvement of epiphora symptoms after surgery between patients who had different preoperative basal Schirmer test values. Patients and Methods: Design: Retrospective comparative case-series study. Participants: Twenty-two consecutive patients (one eye/patient) undergoing surgery for chronic epiphora symptoms resistant to ≥ 6 months of medical treatments (who incidentally had a preoperative basal [oxybuprocain-HCL 0.4 %] Schirmer-test and a postoperative one-year follow-up) were ranked according to their preoperative basal Schirmer test values and divided into two groups of equal size: group I, patients with lower (0 to 6 mm) and group II, patients with higher (7 to 25 mm) Schirmer test values. Intervention: Combination of Piffaretti’s endocanlicular endoscopic lacrimal drainage (22 patients), lacrimal intubation (8 patients), lacrimal punctoplasty (22 patients), lateral canthoplasty (18 patients), and/or conjunctivochalasis (8 patients) surgical procedures. Outcome: Subjective self-perceptions of improvement of their epiphora symptoms was made by the patients one-year after surgery. Results: While between groups I and II mean (± SD) preoperative basal Schirmer test values significantly differed (4 ± 3 mm/ 5 min vs. 10 ± 6 mm/ 5 min, p ≤ 0.001, Mann-Whitney rank sum test), the mean postoperative improvement of epiphora symptoms did not (82 ± 30 % vs. 76 ± 34 %, p = 0.92) and no significant (rho = -0.11, p = 0.62, Spearman rank correlation coefficient) correlation between Schirmer test values and symptoms improvement was found. In both groups > 70 % of patients reported ≥ 70 % (satisfactory) postoperative improvement. Conclusions: In the present study, patients who had different preoperative basal Schirmer test values reported having very similar epiphora symptoms improvement one-year after surgery.

Schlüsselwörter

funktionelle Epiphora - Trockenauge - Feuchtauge - lacrimale Chirurgie - Ballon-Kanthoplastie - nasolacrimalr Intubation - Konjunktivochalasis - Ektropion

Key words

functional epiphora - dry eye - watery eye - lacrimal surgery - balloon canthoplasty - nasolacrimal intubation - conjunvtivochalasis - ectropium

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