Histopathological analysis of lacrimal sac after dacryocystorhinostomy

Abstract

INTRODUCTION: Dacryocystitis is a common ocular problem. It may be acute or chronic. Patient presents with persistent epiphora and regurgitation of mucoid or mucopurulent secretion on application of pressure over lacrimal sac area or on syringing of lacrimal drainage system. Routine lacrimal sac biopsy has been recommended during DCR surgery on the basis of otherwise missing a significant malignancy. With our best knowledge there are very few study regarding histopathological study of lacrimal sac after DCR procedure especially in this part of Nepal, we aim with this study to undertake histopathological examinations of lacrimal sac specimens obtained after DCR operation and to interpret various morphologic patterns, to score the degree of chronic inflammation encountered.

METHOD: It was a prospective observational study conducted over a period of 1 year at Lumbini Eye Institute, Bhairahawa. . All cases of acquired nasolacrimal duct obstruction(ANLDO) who met the inclusion criteria were included in the study. A detailed history followed by examination and clinical diagnostic tests were performed to diagnose ANLDO. External DCR surgery was performed and lacrimal sac specimen was sent for histopathological analysis and compared with similar studies done elsewhere.

RESULT: Total of 245 patients of ANLDO were included in this study. The most common reported histopathological finding was non- specific chronic inflammation with fibrosis confirming the diagnosis of primary process.

CONCLUSION: Histopathological evaluation of the lacrimal sac in patients undergoing DCR surgery for ANLDO revealed chronic non-specific inflammation with fibrosis.