DefinePK

Research Objective

To assess the safety and long-term efficacy of using triamcinolone acetonide (TA) soaked absorbable gel foam dressing in Endoscopic Dacryocystorhinostomy (ENDO-DCR) in the Pakistani population.

Methodology

A quasi-experimental study was conducted on 103 eyes of 98 patients diagnosed with unilateral or bilateral primary acquired nasolacrimal duct obstruction or previously failed ENDO-DCR. The procedure involved ENDO-DCR using a standardized technique with a 30° nasal endoscope. A gel foam soaked with triamcinolone acetonide was placed at the ostium. Anatomical success (patent lacrimal passage on irrigation) and functional success (resolution of epiphora) were assessed at 6 and 12 months. Data was analyzed using SPSS ver 23.0.

Methodology Flowchart

                        graph TD;
    A["Patient Recruitment 103 eyes, 98 patients"] --> B["Perform ENDO-DCR with TA-soaked gel foam"];
    B --> C["Follow-up Assessment"6 & 12 months""];
    C --> D["Document Anatomical & Functional Success"];
    C --> E["Record Complications"];
    D --> F["Data Analysis"];
    E --> F;
    F --> G["Conclusion"];                    

Discussion

The study suggests that ENDO-DCR with triamcinolone acetonide is a safe and effective procedure, potentially improving success rates compared to procedures without adjuvants. The anti-inflammatory properties of steroids are believed to reduce granulation tissue formation and scarring. The study also considered the possibility of the gel foam acting as a mechanical barrier, but evidence from other studies suggests this is less likely to be the primary benefit.

Key Findings

Anatomical success rates were 87.4% at 6 months and 86.4% at 12 months. Functional success rates were 85.4% at both 6 and 12 months. No major complications were observed. Minor complications included one case of secondary hemorrhage and one case of infection in the gel foam.

Conclusion

Endoscopic Dacryocystorhinostomy with triamcinolone acetonide is a safe and effective procedure for symptomatic epiphora secondary to previous failed ENDO-DCR or primary acquired nasolacrimal duct obstruction.

Fact Check

- The study included 103 eyes of 98 patients.
- Anatomical success rate at 6 months was 87.4%.
- Functional success rate at 12 months was 85.4%.

Mind Map