Racial differences in reoperation rates following dacryocystorhinostomy
4 affiliations
- 1Department of Ophthalmology, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem
- 2Institute for Research in Ophthalmology, Foundation for Ophthalmology Development
- 3Goldschleger Eye Institute, Sheba Medical Center
- 4Department of Ophthalmology, Soroka Medical Center, Ben Gurion University of the Negev
Abstract
Background Dacryocystorhinostomy is a commonly performed procedure for nasolacrimal duct obstruction with generally favorable outcomes. However, variability in long-term success has been reported, and the role of racial and ethnic factors remains incompletely understood. This study aimed to assess differences in long-term reoperation risk following dacryocystorhinostomy across racial and ethnic groups. Methods A retrospective multicenter cohort study was conducted using deidentified electronic health records from a global research network (2005–2025). Adult patients undergoing primary dacryocystorhinostomy were included and categorized as White, Asian, Black or African American, or Other. Patients with congenital lacrimal anomalies or malignancy were excluded. Propensity score matching was performed in a 1:1 ratio between each non-White group and White patients, adjusting for demographic characteristics, socioeconomic factors, comorbidities, prior procedures, laboratory parameters, and visit type. Time-to-event analyses were performed using Kaplan–Meier estimation, log-rank tests, and Cox proportional hazards models. The primary outcome was time to reoperation, defined as repeat dacryocystorhinostomy occurring more than 90 days after the index procedure. Results After matching, 1,820 Asian, 744 Black or African American, and 629 patients in the Other group were compared with equal numbers of White patients. Reoperation occurred in 14.0% of Asian patients versus 10.4% of White patients (hazard ratio 1.32, 95% confidence interval 1.09–1.59; P = 0.004). In the Other group, reoperation rates were 11.9% versus 9.9% (hazard ratio 1.58, 95% confidence interval 1.13–2.22; P = 0.007). Among Black or African American patients, reoperation occurred in 11.2% versus 8.6% of White patients, with no statistically significant difference (hazard ratio 1.27, 95% confidence interval 0.92–1.76; P = 0.153). Conclusions Differences in long-term reoperation risk following dacryocystorhinostomy were observed across racial and ethnic groups, with higher risk in Asian and Other groups compared with matched White patients. These findings are hypothesis-generating and should be interpreted in light of the absence of data on surgical technique, operative variables and socioeconomic factors. Prospective studies capturing these variables are needed to clarify underlying mechanisms and support equitable clinical practice in lacrimal surgery. Trial registration Not applicable. Clinical trial number Not applicable.
Related
- Reoperation and Complication Rates Following Percutaneous Bone Graft and Headless Screw Fixation for Scaphoid Non-union: A 10-Year, Single-Centre Experience
- Impact of Suture Configurations for Posterior Horn Meniscal Repair on Postoperative Stability and Reoperation Rates in Patients Undergoing Concurrent Anterior Cruciate Ligament Reconstruction: A Retrospective Comparative Study
- Impact of Social Determinants of Health in Early Pregnancy on Racial and Ethnic Differences in Post-pregnancy Cardiovascular Health
- Association between perioperative statin–ezetimibe therapy and reoperation following arthroscopic rotator cuff repair: A TriNetX database study
- Racial differences in food insecurity among South African adults in 2021: a decomposition analysis.
BibTeX
@article{erdinest2026racial,
title = {{Racial differences in reoperation rates following dacryocystorhinostomy}},
author = {Nir Erdinest and Andrzej Grzybowski and Tehila Shlomov and Itay Nitzan and Ofira Zloto and Denise Wajnsztajn and Ortal Buhbut and Zvi Gur},
journal = {BMC Ophthalmology},
year = {2026},
month = jul,
doi = {10.1186/s12886-026-05139-3},
url = {https://doi.org/10.1186/s12886-026-05139-3},
note = {CC BY},
}
RIS
TY - JOUR
TI - Racial differences in reoperation rates following dacryocystorhinostomy
AU - Nir Erdinest
AU - Andrzej Grzybowski
AU - Tehila Shlomov
AU - Itay Nitzan
AU - Ofira Zloto
AU - Denise Wajnsztajn
AU - Ortal Buhbut
AU - Zvi Gur
PY - 2026
DA - 2026/07/01
JO - BMC Ophthalmology
DO - 10.1186/s12886-026-05139-3
UR - https://doi.org/10.1186/s12886-026-05139-3
AB - Background Dacryocystorhinostomy is a commonly performed procedure for nasolacrimal duct obstruction with generally favorable outcomes. However, variability in long-term success has been reported, and the role of racial and ethnic factors remains incompletely understood. This study aimed to assess differences in long-term reoperation risk following dacryocystorhinostomy across racial and ethnic groups. Methods A retrospective multicenter cohort study was conducted using deidentified electronic health records from a global research network (2005–2025). Adult patients undergoing primary dacryocystorhinostomy were included and categorized as White, Asian, Black or African American, or Other. Patients with congenital lacrimal anomalies or malignancy were excluded. Propensity score matching was performed in a 1:1 ratio between each non-White group and White patients, adjusting for demographic characteristics, socioeconomic factors, comorbidities, prior procedures, laboratory parameters, and visit type. Time-to-event analyses were performed using Kaplan–Meier estimation, log-rank tests, and Cox proportional hazards models. The primary outcome was time to reoperation, defined as repeat dacryocystorhinostomy occurring more than 90 days after the index procedure. Results After matching, 1,820 Asian, 744 Black or African American, and 629 patients in the Other group were compared with equal numbers of White patients. Reoperation occurred in 14.0% of Asian patients versus 10.4% of White patients (hazard ratio 1.32, 95% confidence interval 1.09–1.59; P = 0.004). In the Other group, reoperation rates were 11.9% versus 9.9% (hazard ratio 1.58, 95% confidence interval 1.13–2.22; P = 0.007). Among Black or African American patients, reoperation occurred in 11.2% versus 8.6% of White patients, with no statistically significant difference (hazard ratio 1.27, 95% confidence interval 0.92–1.76; P = 0.153). Conclusions Differences in long-term reoperation risk following dacryocystorhinostomy were observed across racial and ethnic groups, with higher risk in Asian and Other groups compared with matched White patients. These findings are hypothesis-generating and should be interpreted in light of the absence of data on surgical technique, operative variables and socioeconomic factors. Prospective studies capturing these variables are needed to clarify underlying mechanisms and support equitable clinical practice in lacrimal surgery. Trial registration Not applicable. Clinical trial number Not applicable.
SN - 1471-2415
ER -