Purchase this article with an account.
S. Dhar, F. Allard, I. Lee, J. Lee, S. Freitag; Incidence of Recurrent Dacryocystitis After Dacryocystorhinostomy in Patients With Presurgical Dacryocystitis, a Retrospective Case Series Review. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3522.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study is to report the recurrence rate of dacryocystitis in patients who underwent dacryocystorhinostomy(DCR) for dacryocystitis.
A retrospective chart review of all patients with dacryocystitis who underwent DCR with one surgeon, at five clinical centers, was conducted. Patients were included in this study if they had a pre-operative diagnosis of dacryocystitis, underwent DCR, and had at least a one month follow-up period.
A total of fifty eight eyes of fifty two patients met the selection criteria for this study. The average age was 60 years(range 7-89). Average post surgical follow up period was 15 months(range 1-74). Fifty one eyes(87.9%) of forty five patients did not experience recurrent dacryocystitis after DCR, including those who received DCR for bilateral inflammation. Seven eyes(12%) of seven patients were diagnosed with recurrent dacryocystitis after DCR. The average time to recurrence was 9.8 months(range 1-35). Of the seven patients with recurrent post surgical dacryocystitis, four had unusual or resistant bacteria colonizing their nasolacrimal system. The first patient had methicillin resistant Staphylococcus aureus. The second patient had methicillin resistant Staphylococcus aureus, Haemophilus parainfluenzae and alpha hemolytic Streptococcus viridins. The third patient had Escherichia coli and Pseudomonas. The fourth patient had Pseudomonas and Citrobacter freundii. Two of the seven patients with recurrent dacryocystitis were unusual in that one was a chronic cocaine user with a history of severe damage to his nose and sinuses, and significant bone loss. The other patient had surgical pathology consistent with lymphoma.
Overall, the recurrence rate of dacryocystitis in patients who undergo DCR for dacryocystitis is low(12%). Risk factors for recurrent infections appear to be colonization of nasolacrimal systems with unusual or resistant bacteria, distortion of bony anatomy, and in rare cases neoplasm. These patients may benefit from further evaluation and treatment including intensified perioperative antibiotic treatment.
This PDF is available to Subscribers Only