AN ANALYSIS OF PATIENTS WITH CHRONIC DACRYOCYSTITIS

Objective: The purpose of to study was two fold. Firstly, to study the numbers and demographic patterns of patients presenting with chronic dacryocystitis and to study its different presentations. Secondly, to determine in children and adults the indications for simple dacryocystorhinostomy, dacryocystorhinostomy with intubation, dacryocystectomy and canaliculo-dacryocystorhinostomy.Material and Methods: It was a hospital based retrospective case study. We analysed 341 eyes of 313 patients who were suffering from chronic dacryocystitis and were admitted to Khyber Institute of Ophthalmic Medical Sciences, Peshawar, during the period of December 2000 and November 2002.Results: The total numbers of admissions during the period were 6210, thus the patients with chronic dacryocystitis constituted 5.47% of the total admission. The most common age at presentation was over 61 years in 98 cases (31.30%), following by 93 cases (29.71%) between age 40 and 60 years. Females were affected more often than males in 191 cases (61.02%) vs 122 cases (38.97%). Surgery was required on the left side in 159 eyes (46,62%), right side in 154 eyes (45.16%) and bilateral in 28 cases (8.22%). Duration of epiphora was less than one year in 154 eyes (45.01%). The most common presentation was epiphora in 246 eyes (72.14%), followed by mucocoele in 42 eyes (12.31%) and acute on chronic dacryocystitis in 32 eyes (9.38%). The most common indication for surgery was involutional stenosis in 271 eyes (79.47%), followed by congenital nasolacrimal duct obstruction in 61 eyes (17.88%). In adults, simple dacryocystorhinostomy was done in 230 eyes (67.44%) and dacryocystorhinostomy with silicone intubation in 44 eyes (12.90%). Intubation was done in cases of post-traumatic obstruction and in cases with history of failed dacryocystorhinostomies. Dacryocystectomy was required in 5 eyes (1.46%) and canaliculo-dacryocystorhinostomy in one eye (0.29%). In children upto 16 years, dacryocystorhinostomies were performed in 61 eyes (17.88%), in 40 eyes (10.11%) with silicone intubation .and in 21 eyes (7.77%) without intubation. Females were more commonly affected than males. The most common indication for surgery was involutional stenosis and congenital nasolacrimal duct obstruction untreated or improperly treated.Conclusion: Dacryocystorhinostomy alone was the most common operation performed for chronic dacryocystitis.