Daniel R Lefebvre1, Sonya Dhar2, Irene Lee3, Felicia Allard4, Suzanne K Freitag1. 1. Division of Ophthalmic Plastic Surgery, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts;; Department of Ophthalmology, Harvard Medical School, Boston; 2. Department of Ophthalmology, New York University / New York Harbor Healthcare System, New York, New York;; Department of Ophthalmology, Moran Eye Center, Salt Lake City, Utah; 3. Division of Ophthalmology, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence; 4. Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston.
Abstract
PURPOSE: To investigate nonidiopathic causes of external dacryocystorhinostomy (DCR) failure. METHODS: The medical records of all patients with acute or chronic dacryocystitis who underwent external dacryocystorhinostomy performed by the senior author over a 5-year period were retrospectively reviewed, with attention to microbiology, pathology, and associated medical and history. RESULTS: A total of 52 lacrimal systems of 49 patients were included, with a minimum follow-up of 2 months (average, 15.5 months). Surgical success was achieved in 42 systems (87%). Of 7 failures, 6 had a condition potentially associated with an increased risk of failure, including MRSA infection, Gram-negative infection, rhinosinusitis, lymphoma, inflammatory bowel disease, and early loss of lacrimal stents. CONCLUSIONS: External DCR is a successful procedure for the treatment of nasolacrimal obstruction associated with dacryocystitis. Various factors may affect surgical success, and awareness of these factors may enable better patient counseling and surgical planning.
PURPOSE: To investigate nonidiopathic causes of external dacryocystorhinostomy (DCR) failure. METHODS: The medical records of all patients with acute or chronic dacryocystitis who underwent external dacryocystorhinostomy performed by the senior author over a 5-year period were retrospectively reviewed, with attention to microbiology, pathology, and associated medical and history. RESULTS: A total of 52 lacrimal systems of 49 patients were included, with a minimum follow-up of 2 months (average, 15.5 months). Surgical success was achieved in 42 systems (87%). Of 7 failures, 6 had a condition potentially associated with an increased risk of failure, including MRSAinfection, Gram-negative infection, rhinosinusitis, lymphoma, inflammatory bowel disease, and early loss of lacrimal stents. CONCLUSIONS: External DCR is a successful procedure for the treatment of nasolacrimal obstruction associated with dacryocystitis. Various factors may affect surgical success, and awareness of these factors may enable better patient counseling and surgical planning.