Abstract
Purpose :
Acute dacryocystitis is an active infection of the nasolacrimal sac typically caused by nasolacrimal duct obstruction. Patients routinely undergo surgical intervention after infection resolution to prevent recurrence and epiphora, though more recent evidence has advocated for earlier intervention. While success rates among patients who undergo surgery are high, the outcomes of non-surgical cases remain unknown. The present study aims to compare outcomes of acute dacryocystitis patients treated surgically and non-surgically, as well as to evaluate factors which may influence outcomes.
Methods :
A retrospective chart review was conducted though search of electronic medical records to identify patients diagnosed with acute dacryocystitis from 1/1/2013 to 7/1/2023. Patients with no follow-up data were excluded. Manual review was conducted to confirm diagnosis and to extract demographic and clinical information at presentation, as well as medical and surgical treatment data. Primary outcomes included recurrent infection and epiphora at final evaluation. Statistical analyses were conducted using Chi-square test, Fisher’s exact test, and Mann-Whitney U test. A p-value threshold of 0.05 determined statistical significance.
Results :
A total of 62 patients met criteria, of whom 49 (79.0%) were females. Mean age at presentation was 62.37 ± 17.86 years (range 3-96 years). Most patients identified as white (n = 44, 71.0%), followed by unspecified ethnicity (n = 10, 16.1 %) and black (n = 8, 12.9 %). Comorbid sinusitis was present in 22 (35.5 %) patients. At presentation, 50 (80.6%) patients reported epiphora. Forty-six (74.2%) patients underwent surgical intervention, with the most common procedure being dacryocystorhinostomy (84.8%). Recurrent infection occurred in 5 patients—2 (12.5%) in the non-surgical cohort and 3 (6.5%) in the surgical cohort. The proportion of patients without epiphora at final evaluation was higher in the surgical cohort (n = 37, 80.4%) compared to the non-surgical cohort (n = 8, 50.0%) to a statistically significant degree (p = 0.026). Absence of epiphora was not significantly associated with age, sex, ethnicity, or comorbid sinusitis.
Conclusions :
Patients with acute dacryocystitis who are treated non-surgically are more likely to experience recurrent infection and result with epiphora than those who undergo surgery independent of patient age, sex, ethnicity, and comorbid sinusitis.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.