Dacryocystitis Comparative Study

Background: Chronic dacryocystitis is the commenst cause of lacrimal passage obstruction indicates inflammation of lacrimal sac. Dacryocystorhinostomy (DCR) is the preliminary choice of surgical procedure in which lacrimal sac is connected with nasal mucosal flap by bypassing nasolacrimal duct.

Objectives: This comparative study describes and evaluates the effectiveness of conventional D.C.R method and D.C.R implant method in chronic dacryocystitis cases.

Materials and methods: The present comparative study consists of 200 patients with complaint of watering, pus discharge and diagnosed as chronic dacryocystitis. Out of which 160 cases were followed up for a period of 3-6 months. Study cases were operated by using “Pawar implant”.

Results:

Group 1 cases again sub divided in to 2 sub-groups as follows sub-group (i) consists of 4 patients having bilateral chronic dacryocystitis and sub-group (ii) consists of 41 patients having unilateral chronic dacryocystitis.

Group 2: consists of 115 cases of chronic dacryocystitis were operated by D.C.R. implant method. Group 2 cases again sub-divided into 3 sub-groups as follows- sub-group (i) – consists of 10 cases of chronic dacryocystitis having bilateral involvement, Sub-group (ii) – consists of 80 cases of chronic dacryocystitis were unilateral involvement occurred and Sub-group (iii) – consists of 25 cases where already D.C.T. was done.

RESULTS

In present study, two hundred cases of chronic dacryocystitis were operated and used “Pawar implant”, out of which 160 cases were followed up for a period of 3-6

method, in which deviated nasal septum was associated. No such occlusion of drainage was reported in D.C.R. implant method, but 5 (20%) cases were reported where D.C.T. was already done (Table 3). Bleeding occurred during operation was much more in conventional D.C.R. (53.3%) method than D.C.R. implant method (7.7%) (Table 4). Studies suggested that high rates of haemorrhage during surgery is major drawback of conventional D.C.R (13). Complete patency of nasolacrimal duct was observed in 125 cases i.e. 76 cases in D.C.R. implant method, 35 cases in Conventional D.C.R. method and 14 cases in D.C.R implant after D.C.T done. Partial patency of naso lacrimal duct was observed in 22 cases and failure of patency was seen in 11 cases (Table 6).

CONCLUSION

Disease of conjunctival sac, nose and para-nasal sinuses also contribute in the obstruction of naso-lacrimal passage. The mobility of patients was observed earlier where D.C.R. implant method was adopted than the conventional D.C.R. method. Bleeding occurred during operation was much more in conventional D.C.R. (53.3%) method than D.C.R. implant method (7.7%). Conventional D.C.R. method is a time consuming process than D.C.R. implant method. The patency of naso-lacrimal duct was observed. Much better results are seen in D.C.R. implant method than conventional D.C.R.