BACTERIOLOGY OF LACRIMAL DUCT OBSTRUCTION IN ADULTS

Aims-To determine the current bacteriology of lacrimal duct obstructio n (LDO) and to relate the bacteriological findings to the type of symp toms. Methods-127 samples were obtained from the lacrimal sac in 118 c onsecutive adult patients with LDO, including nine bilateral cases. Re sults-Altogether, 156 isolates were recovered from the 127 samples cul tured. Cultures were positive from 84% of the samples. Gram positive b acteria were isolated in 79 (62%) samples. The most frequently culture d bacterial species was Staphylococcus epidermidis, representing 27% o f the isolates. Gram negative bacteria were recovered from 26 (20%) sa mples, and these bacteria were statistically significantly more common in cases with copious discharge than in cases with minor discharge (p = 0.000). Cases with simple stenosis of the lacrimal duct (SSLD) show ed significantly less Streptococcus sp (p = 0.004) and Gram negative o rganisms (p = 0.004) than those with chronic dacryocystitis. Conclusio n-The bacteriology of SSLD resembles that of normal conjunctival flora . Chronic dacryocystitis in adults is associated with an increased pro portion of Gram negative bacteria which may be a reservoir for postope rative intraocular infection. They should also be taken into account i n selecting antimicrobial prophylaxis in lacrimal drainage surgery.