A Five-Year Retrospective Review of the Clinical Spectrum and Management Pattern of Dacryocystitis in a Tertiary Care Hospital of Coastal Karnataka

Abstract

BACKGROUND Dacryocystitis is the most common pathology affecting lacrimal drainage system, representing 79 - 87 % of all lesions. This retrospective study was conducted to understand the clinical spectrum and management patterns of dacryocystitis in the past 5 years in a tertiary care hospital of coastal Karnataka. METHODS This is a five-year retrospective review of the case records of patients with dacryocystitis from the year 2015 to 2019. The records were retrieved from the electronic medical record system of the hospital using the International Statistical Classification (ICD) 10 codes. Data retrieved included, demographic profile, clinical history, presenting symptoms, past surgical interventions, examination findings, systemic comorbidities, pattern of management, medical or surgical management and complications if any. 45 cases that had completed medical records were included in the study. RESULTS The mean age of presentation was 49.37 (± 19.59). The condition was more common in females with a male to female ratio of 1:2.5. The condition was almost equal on both sides. 11 (24.44 %) had bilateral involvement. The patients were mostly from coastal areas or dry plains. Most common presentation was chronic dacryocystitis. Aggravated epiphora was the most common symptom (33) 73.3 %. Diabetes mellitus (15) and hypertension (10) were the most common systemic comorbidities. (22) 48.8 % had no comorbidities. The complications seen were (4) 8.9 % fistula, (1) 2.2 % lacrimal abscess, (2) 4.4 % conjunctivitis and (1) 2.2 % preseptal cellulitis. The patients who underwent nasal examination were (31) 68.9 % out of which, 26 had no abnormal finding in the nose. Surgical treatment was performed in 29 (64.4 %) mainly in the form of dacryocystectomy (DCT) 24 (53.3 %) while only 5 (11.1 %) underwent conventional dacryocystorhinostomy (DCR). CONCLUSIONS Chronic dacryocystitis is the most common form of presentation with higher incidence in the females in the fifth decade of life. Epiphora was the commonest symptom. Most patients who underwent a preoperative nasal examination did not have any pathology. DCT was the more commonly performed procedure. KEYWORDS Acute Dacryocystitis, Chronic Dacryocystitis, Dacryocystectomy, Dacryocystorhinostomy, Epiphora