Long-Term Outcomes and Predictors of Postoperative Complications After Endoscopic Conjunctivodacryocystorhinostomy

To evaluate the clinical outcomes of endoscopic conjunctivodacryocystorhinostomy with Jones tube placement and to identify patient- and surgery-related risk factors for postoperative complications.

This single-center, retrospective case series analyzed 42 consecutive patients (42 eyes) who underwent endoscopic conjunctivodacryocystorhinostomy. Data were collected on patient demographics, comorbidities, and surgical variables, including Jones tube diameter (3.5 vs. 4.0 mm). Primary outcomes were anatomical and functional success. The primary endpoint for risk factor analysis was the occurrence of any postoperative complication. Univariate and multivariable logistic regression analyses were performed to identify significant predictors of adverse outcomes.

Over a mean follow-up of 4.6 years, the anatomical success rate was 83.3%, while the functional success rate was 66.7%. Tube displacement was a common complication, occurring in 23.8% of cases. In multivariable analysis, the use of a larger 4.0-mm tube was significantly protective against complications (adjusted odds ratio: 0.35, p = 0.007), whereas a diagnosis of preoperative dry eye disease significantly increased the risk (adjusted odds ratio: 1.71, p = 0.028). The benefit of the larger tube was primarily driven by a statistically significant reduction in the rate of tube displacement compared with the 3.5-mm tube (5.3% vs. 27.3%, p = 0.03).

Larger-diameter (4.0 mm) Jones tube significantly reduces complications in endoscopic conjunctivodacryocystorhinostomy (particularly tube displacement), whereas preexisting dry eye symptoms were found to be associated with increased postoperative complications.