The evaluation of techniques of dacriosistorinostomy: A meta-analysis study

Purpose: Dacryocystorhinostomy (DCR) is applied for treatment of lacrimal drainage obstruction. "External" and "Endonasal" approaches are preferred in DCR. In this study, DCR techniques, one (anterior/posretior) or double (both anterior and posterior) flaps DCR of anastomosis and using of silicone tube intubations are compared to identify the success rates. Methodology: DCR publications between 1933 and 2014 are screened during six months by using Pubmed database. "Dacryocystorhinostomy", "External DCR", "Endoscopic DCR", "Flap + DCR" and "Silicone Tube Intibation" are identified as keywords. First, data is analyzed by using SPSS ver.18 software to explore the descriptive statistics. Then, using Comprehensive Meta Analysis (CMA ver.2) software, Mantel Haenszel method is preferred to calculate Odds Ratio (OR) in terms of fixed effect. Results: 3,372 publications are screened in Pubmed. For inclusion criteria, samples are adult patients and publications, written in english between 1933 and 2014, are comperative, retrospective and prospective. There are 38 studies for DCR techniques (n: 3,839), 25 studies for flap comparision (n: 2,186) and 43 studies for silicone tube intubations (n:3,011). After meta analysis process in 95% confidence interval, OR:1,263 (p:0,014) is for comparison of External and Endoscopic DCR, OR: 0,309 (p:0,000) is for flap anastomosis comparision, OR: 1,033 (p:0.005) is for usage of silicone tube intubations in Endoscopic DCR and OR: 0,148 (p:0.774) is for usage of silicone tube intubations in External DCR. Conclusion: Compared to external and endoscopic DCR tehcniques, external DCR is statistically more successful than endoscopic DCR. There is no difference between double flap DCR and one flap DCR considering the success rates. Using silicone tube intubations in external and endoscopic DCR doesn't effect the success rate of surgery. Keywords: Dacryocystorhinostomy, External DCR, Endoscopic DCR, Flap, Silicone Tube Intibation, meta analysis.