Increased dacryocystorhinostomy (DCR) failure in patients with gastro-esophageal reflux disease (GERD) and primary acquired nasolacrimal duct obstruction (PANDO)
What:
Paper Presentation | Présentation d'article
Part of:
When:
1:42 PM, Friday 1 Jun 2018
(6 minutes)
Where:
Metro Toronto Convention Centre (South Building)
- Room 714 A
How:
Authors: Nirojini Sivachandran, Ahsen Hussain, John Harvey
Author Disclosure Block: N. Sivachandran: None. A. Hussain: None. J. Harvey: None.
Abstract Body:
Purpose: To determine whether patients with primary acquired nasolacrimal duct obstruction (PANDO) undergoing repeat dacryocystorhinostomy (DCR) are more likely to have co-morbid gastroesophageal reflux disease (GERD).
Study Design: Retrospective chart review and phone interview. Patients who had failed primary DCR surgery (defined as continued symptoms, a blocked tear duct on syringing in clinic postoperatively and repeat surgery).
Methods: A list of patients who had DCR surgery over a 10-year period from 2006 to 2016 was acquired. Charts were reviewed to identify patients who had failed DCR surgery and for any past medical history of treated or untreated GERD. Patients were contacted by telephone to identify whether patients had undiagnosed/unreported GERD by use of the validated Reflux Disease Questionnaire (RDQ). Anyone with a past medical history of GERD or on medications for acid repression or RDQ score >15 were considered to have GERD.
Results: There were 58 of the 509 patients who underwent repeat DCR surgeries. Of these 58 only 46 met the study criteria. Of these 46 our phone response rate was only 63.0%, and the remainder of the patients had retrospective chart review. Though not statistically significant more patients with GERD failed DCR compared to those without GERD, 34.7% and 26.7% respectively. However, patients with PANDO and GERD were 2.3x more likely to fail DCR surgery than patients without PANDO and GERD, 24.0% vs. 10.7%, p < 0.05.
Conclusions: The pathogenesis of PANDO is poorly understood and GERD has been postulated to play a role. Patients with PANDO and GERD are 2.3x more likely to fail DCR surgery.
Author Disclosure Block: N. Sivachandran: None. A. Hussain: None. J. Harvey: None.
Abstract Body:
Purpose: To determine whether patients with primary acquired nasolacrimal duct obstruction (PANDO) undergoing repeat dacryocystorhinostomy (DCR) are more likely to have co-morbid gastroesophageal reflux disease (GERD).
Study Design: Retrospective chart review and phone interview. Patients who had failed primary DCR surgery (defined as continued symptoms, a blocked tear duct on syringing in clinic postoperatively and repeat surgery).
Methods: A list of patients who had DCR surgery over a 10-year period from 2006 to 2016 was acquired. Charts were reviewed to identify patients who had failed DCR surgery and for any past medical history of treated or untreated GERD. Patients were contacted by telephone to identify whether patients had undiagnosed/unreported GERD by use of the validated Reflux Disease Questionnaire (RDQ). Anyone with a past medical history of GERD or on medications for acid repression or RDQ score >15 were considered to have GERD.
Results: There were 58 of the 509 patients who underwent repeat DCR surgeries. Of these 58 only 46 met the study criteria. Of these 46 our phone response rate was only 63.0%, and the remainder of the patients had retrospective chart review. Though not statistically significant more patients with GERD failed DCR compared to those without GERD, 34.7% and 26.7% respectively. However, patients with PANDO and GERD were 2.3x more likely to fail DCR surgery than patients without PANDO and GERD, 24.0% vs. 10.7%, p < 0.05.
Conclusions: The pathogenesis of PANDO is poorly understood and GERD has been postulated to play a role. Patients with PANDO and GERD are 2.3x more likely to fail DCR surgery.
