Purpose: The purpose of the present study is to report authors' experience of primary powered endoscopic dacryocystorhinostomy in the setting of acute dacryocystitis and lacrimal sac abscess.
Methods: A prospective interventional case series of 20 primary powered endoscopic dacryocystorhinostomies were performed in 20 patients presenting with acute dacryocystitis and lacrimal sac abscess at a tertiary eye care center from April to December 2013. None of the patients received preoperative antibiotics. All cases were operated by single surgeon (M.J.A.) using a standard described technique. All patients were intubated for 6 weeks. A minimum follow up of 6 months after stent removal was considered for the final analysis. The main outcome measures were the resolution of infection and the anatomical and functional successes of the surgical procedure.
Results: The mean age at presentation was 39.2 years. Sixty percent of patients (12/20) presented with acute dacryocystitis, 35% (7/20) with a lacrimal abscess, and 5% (1/20) with a dacryopyocele following a failed probing. None of the cases received preoperative antibiotics. Ten percent of patients (2/20) underwent additional septoplasty. All the cases showed resolution of pain and swelling at 1 week follow up. Two patients were noted to have small edge granulomas of the ostium, which were successfully managed by focal excision. At the final follow up, anatomical success was achieved in 95% (19/20) and functional success in 90% (18/20) of the patients.
Conclusions: Primary powered endoscopic dacryocystorhinostomy is an effective modality in the management of acute dacryocystitis and lacrimal abscess, and result in rapid resolution of the disease.