Epidemiology of Chronic Dacryocystitis and Success Rate of External Dacryocystorhinostomy in Nepal

Department of Ophthalmology, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal.
Orbit 06/2005; 24(2):79-82. DOI: 10.1080/01676830490916073
Source: PubMed


To study the epidemiology of chronic dacryocystitis and the success rate of external dacryocystorhinostomy (DCR) in Nepal. Patients and
This is a retrospective descriptive and interventional case series. A total of 662 records of patients with chronic dacryocystitis due to nasolacrimal duct obstruction, who were treated by means of external DCR without bicanalicular silastic tube intubation, were studied.
Mean for age with standard deviation and confidence intervals were calculated. The significance of the difference in means was calculated using the unpaired t-test.
Of 662 patients, 67.6% were female. The mean age of the patients was 27.4 +/- 13.7 years (SE = 0.53, 95% CI = 26.34-28.46). Chronic dacryocystitis due to nasolacrimal duct obstruction was found in 86 patients (13.0%) from the high hills (mean age = 35.3 +/- 11.4 years, 95% CI = 32.85-37.75), but most patients (576, 87.0%) were from the subtropical lowlands with a monsoon climate (mean age = 26.9 +/- 13.3 years, 95% CI = 25.8-28.0; p = < 0.01). An overall success rate of 88.6% (89.8% for high-hill patients and 87.4% for those from the lowlands) was obtained after DCR.
Chronic dacryocystitis is more common in the subtropical plains of Nepal with a monsoon climate than in the high hills. It is predominantly found in pre-menopausal females. External DCR without bicanalicular silastic tube intubation is an effective method for treating chronic dacryocystitis due to NLDO in these patients.

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    • "In general, the disease had predilection to the left side, especially in females, because of their narrow bony canal. The nasolacrimal duct and the lacrimal fossa formed a greater angle on the right side than on the left side.[789101112] "
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    ABSTRACT: Background:Dacryocystorhinostomy (DCR) is widely accepted as the procedure of choice for surgical correction of lacrimal drainage system obstruction distal to common canaliculus in adulthood. Although, there are only limited epidemiological data available in Iran about the patients undergoing DCR surgery.Aim:This study was aimed to survey the demographic characteristics of patients received (DCR) surgery to achieve the newer information about these patients.Subjects and Methods:In this descriptive study, the demographic characters such as age, and gender, clinical findings, history of surgery, etc., extracted from archived files of the patients undergoing DCR surgery in educational and treatment center of Bu Ali Sina Hospital in Mazandaran. Data were entered into the SPSS software version 15 (Chicago, IL, USA) and analysis inferential analysis performed using t-test and Chi-square.Results:Among 40 under survey records 72.5% (29/40) were female and 27.5% (11/40) male. Patient's mean age was 48.22 (17.1). Fifty percent were from a rural area and there was a significant relationship between gender and dacryocystitis rate, it was high among female (P = 0.02(Most of the patients complained of tearing 87.5% (35/40) and recurrent attacks of acute dacryocystitis 70.3% (28/40), respectively. Conjunctivitis in 33.3% (13/40) of patients and chronic discharge was seen in 40% (16/40) of cases.Conclusion:Overall finding showed in comparisons of men with the females of middle age and above included higher cases of dacryocystitis. The authors suggest regarding high prevalence of sinusitis and allergies in Northern Iran, checking by ENT specialist is beneficial to exact diagnosis and programming for treatment of this kind of patients.
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    • "The pattern of the relative incidence of various factors varies in different studies. In our study, females were found to be commonly affected in congenital and acquired dacryocystitis, with a male to female ratio of 2.3: 1, which correlated with the findings of Badhu B et al., [5] (2.1: 1). The predilection in females may be due to the smaller nasolacrimal canal diameter in females than in men and hormonal factors [6]. "
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    ABSTRACT: Introduction: Dacryocystitis is an inflammation of the lacrimal sac and duct. It is an important cause of ocular morbidity, both in children and in adults.
    Full-text · Article · May 2012 · Journal of Clinical and Diagnostic Research
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    • "The success of conventional primary external DCR with or without mucosal flap is 85% to 99%. The success rate reported from this part of Nepal is 88.6% (Badhu et al 2005). "
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    ABSTRACT: chronic dacryocystitis is a common ophthalmic problem almost always requiring surgery as the only definitive treatment. to compare the perioperative outcome of external DCR surgery under local anesthesia with and without sedation. one hundred consecutive patients with chronic dacryocystitis undergoing dacryocystorhinostomy (DCR) surgery were randomly divided into two groups using computer generated random table. Group A underwent DCR under local anesthesia (LA) without sedation and group B under LA with sedation. The outcome parameters were intra-operative pain, surgeon's comfort, intra-operative complications and duration of surgery. SPSS version 11.5 software was used. Chi square test was used to compare the difference between the groups. there were 50 patients in each group. The mean age +/- SD of the patients was 34.4 +/- 12.12 years (95% CI=28.89-38.55 years). Sixty-nine percent of them were female. Significantly higher number of patients experienced pain in Group A as compared to Group B (100% vs 50%, P<0.001) Surgeon's discomfort was significantly present in group A as compared to group B (70% vs 10%), (p=0.00001). Blood loss was significantly more in group A than in group B (p=0.017). There was no significant difference in the duration of surgery. The post operative success rate in both the groups was comparable after six months of followup. the use of sedation with LA improves the perioperative outcome of DCR surgery in terms of patient's pain, surgeon's comfort and intra-operative complications.
    Preview · Article · Sep 2010 · Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH
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