Congenital lacrimal fistula

PURPOSE. Congenital lacrimal fistula is a rare abnormality of the lacrimal system. The patients may be asymptomatic but treatment of those with sympto ms such as epiphora and dacryocystitis is still controversial. METHODS. The clinical findings, methods of surgical treatment and results w ere evaluated in seven patients (four male, three female) with congenital l acrimal fistula. Three were asymptomatic, types of surgical treatment were fistula excision with dacryocystorhinostomy (DCR) (two cases), fistula exci sion with conjunctival DCR (one case) and closed fistula excision alone (on e case). RESULTS. Three of the four patients who underwent surgery had relief of sym ptoms. The fistula recurred in the case that had undergone fistula excision alone. CONCLUSIONS. It is difficult to design controlled studies to detect which m ethod is superior for the treatment of lacrimal fistula, considering the sm all number of cases in the literature. We recommend treating each case acco rding to ifs own characteristics.