The role of dacryocystography in the management of patients with epiphora.

A retrospective study has been carried out on 114 patients who have undergone dacryocystography (DCG) for epiphora, to assess the role of DCG in their management. It was found that 16/66 (24%) patients who were offered surgery after DCG refused it or were assessed as unfit for surgery, demonstrating the need for careful counselling and assessment of patients prior to investigation. The presence of lacrimal system obstruction on DCG was an important factor in determining whether a patient underwent lacrimal surgery. However, the actual level of the obstruction influenced neither the likelihood of a patient undergoing lacrimal surgery nor the form of lacrimal surgery undertaken. This suggests that, unless the surgical approach will be modified in the light of the anatomical information furnished by DCG, DCG is not necessary. Lacrimal scintigraphy would provide sufficient information for the practical management of epiphora. Syringing of the lacrimal system correlates poorly with DCG in detecting obstruction.