Clinical Profile and Management Outcome of Acute Dacryocystitis: Two Decades of Experience in a Tertiary Eye Care Center
Clinical Profile and Management Outcome of Acute Dacryocystitis: Two Decades of Experience in a Tertiary Eye Care Center
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DOI：
10.3109/08820538.2013.833269
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发表时间：
2015-03-01
影响因子：
1.7
通讯作者：
Honavar, Santosh G.
中科院分区：
文献类型：
--
作者：
Ali, Mohammad Javed;Joshi, Surbhi D.;Honavar, Santosh G.
目的：报告急性泪囊炎的人口统计学特征、临床表现和治疗结果。研究方法：回顾性研究了1990年1月至2012年3月22年间因急性泪囊炎就诊于三级眼科护理中心眼科整形诊所的320例患者的347只眼，对人口统计学特征、临床表现和管理结局进行了审查。检索同期患有泪道疾病的患者数量，以评估急性泪囊炎的发生率。成功的解剖结局定义为冲洗通畅，成功的功能结局定义为感染和溢泪消退。结果：平均发病年龄为37岁。男女比例为2：1。左右眼的偏侧性无差异。在8.4%（27/320）的患者中观察到双侧疾病。23%（80/347）的眼表现为泪囊脓肿，2.8%（10/347）的眼表现为眼眶蜂窝织炎。4.4%（14/320）的患者需要住院接受重症医学护理。急性症状缓解的平均时间为10天。5.6%（18/320）的患者发生了瘘管，其中83%（15/18）的患者是在泪囊脓肿自发性破裂后发生的。82.5%（264/320）的患者进行了泪囊鼻腔吻合术，解剖成功率为94.5%，功能成功率为93.5%。结论：急性泪囊炎占所有泪系统疾病患者的2.4%。瘘管形成是一种后遗症，更常见的自发性破裂的泪腺脓肿。急性泪囊炎患者的长期结局良好，手术成功率为94.3%。
Aim: To report the demographic profile, clinical presentation, and management outcome of acute dacryocystitis. Methods: Retrospective study of 347 eyes of 320 patients, who presented to the Ophthalmic Plastic Clinic of a tertiary eye care center over a period of 22 years from January 1990 to March 2012 with acute dacryocystitis, were reviewed for demographic profile, clinical presentation, and management outcome. The numbers of patients with lacrimal disorders during the same period were retrieved to assess the incidence of acute dacryocystitis. Successful anatomical outcome was defined as patency on irrigation and a successful functional outcome was defined as resolution of infection and epiphora. Results: The mean age at presentation was 37 years. The female to male ratio was 2:1. There was no difference in the laterality between the right and the left eyes. Bilateral disease was noted in 8.4% (27/320) patients. 23% (80/347) eyes presented with lacrimal abscess while 2.8% (10/347) eyes had orbital cellulitis. Intensive medical care with hospital admission was needed in 4.4% (14/320) patients. The mean time to resolution of acute symptoms was 10 days. 5.6% (18/320) patients developed a fistula, among which 83% (15/18) were following a spontaneous rupture of the lacrimal abscess. Dacryocystorhinostomy was performed in 82.5% (264/320) patients with an anatomical success of 94.5% and a functional success of 93.5%. Conclusions: Acute dacryocystitis comprises 2.4% of all patients presenting with lacrimal system disorders. Fistula formation is a sequel more commonly seen with spontaneous rupture of a lacrimal abscess. The long-term outcomes in patients presenting with acute dacryocystitis are good with a surgical success rate of 94.3%.