DACRYOCYSTECTOMY - SURGICAL INDICATIONS AND RESULTS IN 25 PATIENTS

The main indication for dacryocystectomy (DCT) is excision of lacrimal sac tumors. DCT may be considered less invasive than dacryocystorhino stomy (DCR) because lacrimal bone and nasal mucosa are not violated. T o determine other indications for DCT, we performed a retrospective re view of all patients who underwent DCT from the Oculoplastics Division , Department of Ophthalmology, UMD-New Jersey Medical School from July 1983 through July 1994. Patients with lacrimal sac tumors were exclud ed from the study. All 25 patients in the study demonstrated complete nasolacrimal duct obstruction (NLDO) and dry eye with minimal preopera tive complaints of tearing. Nine of 25 patients also had systemic medi cal problems making them at medical risk for local anesthesia with mon itored sedation. Four of 25 patients had underlying medical conditions (ocular cicatricial pemphigoid [OCP], Crohn's disease, and systemic l upus erythematosus) that might predispose them to nasal scarring after standard DCR. None of the 25 patients required secondary hospital adm ission and no patient demonstrated or complained of significant tearin g that affected daily function after DCT. Although DCR is the standard for improving lacrimal outflow, we conclude that DCT is a useful alte rnative to it in selected patients with underlying dry eye and other m edical conditions.