Objective: To compare the demographic characteristics and presentation of patients having dacryolithiasis with those who are free of stones at the time of dacryocystorhinostomy.
Design: Retrospective, comparative case series.
Participants and intervention: Patients undergoing treatment in the Lacrimal Service at Moorfields Eye Hospital between 1989 and 1999. Group 1 patients, with lacrimal sac stones found at lacrimal surgery, were compared with three other groups undergoing open lacrimal surgery: a stone-free group with epiphora only (group 2), a stone-free group with dacryocystitis (group 3), and a consecutive cohort of unselected patients operated on over a 5-week period (group 4).
Main outcome measures: Patient demographic characteristics, duration of epiphora, or a history of preceding dacryocystitis were related to the presence or absence of dacryoliths.
Results: Thirty-six patients (22 female; 61%) between the ages of 19 and 85 years (mean, 53.8 years; median, 52.5 years) had either single (22 cases; 61%) or multiple dacryoliths. Half of these patients had previous attacks of dacryocystitis. Group 1 patients (with stones) sought treatment earlier than all of the other groups: 13.5 months compared with 36.5 months (group 2; P = 0.01), 48.7 months (group 3; P = 0.05), and 52.2 months (group 4; P = 0.02). Group 1 patients are much more likely to have prior attacks of dacryocystitis than patients without stones (18/36 in group 1, 10/45 in stone-free patients; P = 0.009). In all groups, there was a slight preponderance of females, but there was no difference in gender or age at presentation.
Conclusions: Patients with dacryolithiasis are likely to have a shorter history of epiphora and previous attacks of dacryocystitis at presentation. There is no gender or age difference between the lacrimal stone and stone-free patients undergoing open lacrimal surgery.