Ophthalmology Outcomes
Oculoplastic Surgery
The Ophthalmic Plastic Surgery Service performs a high volume of specialized treatments and surgeries to address eyelid and orbital disease and trauma.
Learn more about the serviceReoperation Rate for Primary External Dacryocystorhinostomy (Ex-DCR) Surgery at Six Months Follow-up
During the 2022 calendar year, the Mass Eye and Ear Ophthalmic Plastic Surgery Service performed Ex-DCR procedures on 59 lacrimal systems of 51 patients. Three patients were excluded for pre-existing lacrimal conditions. Exclusion criteria include previous systemic diagnosis of granulomatosis with polyangiitis or sarcoidosis, benign or malignant lacrimal system neoplasms, post-traumatic lacrimal obstruction, and congenital lacrimal obstruction. Three patients were excluded because of a history of prior lacrimal surgery. One patient had both pre-existing lacrimal conditions (benign lacrimal system neoplasm) and a history of prior lacrimal surgery. Therefore, this analysis includes the 51 lacrimal systems of 44 patients who underwent primary Ex-DCR in 2022 for primary acquired nasolacrimal duct obstruction (PANDO). Of these, zero required a second procedure within six months. Similar results were reported for the past seven calendar years.
Ex-DCR is a common surgical method for PANDO. A review of the literature suggests that 7.8% to 12.5% of patients require reoperation following primary external DCR for PANDO.1-3
Reoperation Rate for Primary Endoscopic Dacryocystorhinostomy (En-DCR) Surgery at Six Months Follow-up
During the 2022 calendar year, the Mass Eye and Ear Ophthalmic Plastic Surgery Service performed En-DCR procedures on 58 lacrimal systems of 44 patients. Eleven lacrimal systems of ten patients were excluded for pre-existing lacrimal conditions. Exclusion criteria include previous systemic diagnosis of granulomatosis with polyangiitis or sarcoidosis, benign or malignant lacrimal system neoplasms, post-traumatic lacrimal obstruction, and congenital lacrimal obstruction. Eleven lacrimal systems of six patients also were excluded because of a history of prior lacrimal surgery. Two lacrimal systems of two patients had both a pre-existing lacrimal condition and a history of prior lacrimal surgery. This analysis includes the remaining 34 lacrimal systems of 26 patients who underwent primary En-DCR in 2022 for primary acquired nasolacrimal duct obstruction (PANDO). Two of these 34 eyes (5.9%) required a second procedure within six months.
A review of the literature suggests that 2% to 11% of patients who undergo primary En-DCR for primary acquired PANDO require a revision.1-4
Reoperation Rate for Upper Lid Surgeries at Six Months Follow-up
During the 2022 calendar year, the Mass Eye and Ear Ophthalmic Plastic Surgery Service performed upper blepharoplasty and/or ptosis repair surgeries on 1024 eyelids in 596 patients. These upper lid surgeries included cosmetic eyelid surgery and functional eyelid surgery, including in patients with other medical conditions, such as neurogenic ptosis, myogenic ptosis, congenital ptosis, and thyroid eye disease. Of these 1024 lids, 127 were excluded from analysis because they had undergone prior lid surgery, including blepharoplasty, ptosis repair, or lid surgeries in the setting of tumor removal or orbital decompression. This left 897 lids for analysis. Of these 897 lids, twenty-nine (3.2%) required a second procedure within six months.
A review of the literature suggests that reoperation rates after eyelid surgery range from 2.6% to 8.7%.1-2
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Reoperation Rate for Primary External Dacryocystorhinostomy (Ex-DCR) Surgery at Six Months Follow-up
1. Dolman PJ. Comparison of external dacryocystorhinostomy with nonlaser endonasal dacryocystorhinostomy. Ophthalmology 2003; 110(1):78-84. 2
2. Karim R, Ghabrial R, Lynch TF, et al. A comparison of external and endoscopic endonasal dacryocystorhinostomy for acquired nasolacrimal duct obstruction. Clin Ophthalmol 2011; 5: 979-989.
3. Ben Simon GJ, Joseph J, Lee S, et al. External versus endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction in a tertiary referral center. Ophthalmology 2005; 112(8): 1463-1468.
Reoperation Rate for Primary Endoscopic Dacryocystorhinostomy (En-DCR) Surgery at Six Months Follow-up
1. Dolman PJ. Comparison of external dacryocystorhinostomy with nonlaser endonasal dacryocystorhinostomy. Ophthalmology 2003; 110(1): 78-84.
2. Ben Simon GJ, Joseph J, Lee S, et al. External versus endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction in a tertiary referral center. Ophthalmology 2005; 112(8): 1463-1468.
3. Moore WMH, Bentley CR, Olver JM. Functional and anatomic results after two types of endoscopic endonasal dacryocystorhinostomy: surgical and holmium laser. Ophthalmology 2002; 109(8): 1575-1582.
4. Codère F, Denton P, Corona J. Endonasal dacryocystorhinostomy: a modified technique with preservation of the nasal and lacrimal mucosa. Ophthal Plast Reconstr Surg 2010; 26(3): 161-164.
Reoperation Rate for Upper-Lid Surgeries at Six Months Follow-up
1. Scoppettuolo E, Chadha V, Bunce C, et al. British Oculoplastic Surgery Society (BOPSS) National Ptosis Survey. Br J Ophthalmol 2008; 92(8): 1134–1138.
2. Melicher J, Nerad JA. Chapter 29: Ptosis surgery failure and reoperation. In: Cohen AJ, Weinberg DA, eds. Evaluation and management of blepharoptosis. New York: Springer; 2011, 269-274.
