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SJ Morgan, MW Austin, H Whittet; The Treatment of Acute Dacryocystitis Using Laser-assisted Endonasal Dacryocystorhinostomy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1570.
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Purpose: To determine whether acute dacryocystitis complicated by abscess formation can be successfully treated using laser-assisted endonasal dacryocystorhinostomy (LE-DCR). Method: A protocol was adopted for the management of acute dacryocystitis presenting to the Ophthalmology department of our hospital. All patients were assessed jointly by an Ophthalmologist and Otolaryngologist for their suitability for primary internal drainage via a nasal endoscopic approach. All suitable patients during the study period August 1999 to November 2000 were managed by intravenous antibiotics and Holmium YAG laser Dacryocystorhinostomy. Results: 12 patients were studied (mean age 75 years (range 39 to 82 years), 2 male, 10 female). A history of chronic epiphora was found in 83% of patients, and recurrent nasolacrimal infections in the same 83%. Resolution of symptoms and signs of acute dacryocystitis occurred in all 12 patients. Further surgical procedures were not required in any patients and no recurrence of acute dacryocystitis occurred during the median follow up period of 9 months (range 6 to 27 months). Ostium patency defined as the absence of epiphora and the observation of irrigated lacrimal fluorocein at the ostium was achieved in 83% of patients. Epiphora recurred in 17% of cases. Conclusion: Laser-assisted endonasal dacryocystorhinostomy is an effective primary treatment in cases of acute dacryocystitis complicated by abscess formation. In addition, pre-existing symptoms of epiphora and recurrent nasolacrimal infections are relieved in the majority of patients.
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