OUTCOME OF DACRYOCYSTECTOMY IN ELDERLY PATIENTS ATTENDING A TERTIARY CARE CENTRE IN KASHMIR

Abstract

Background: Dacryocystectomy (DCT) is a surgical procedure that involves complete removal of lacrimal sac. It is a less invasive procedure and can be used as an alternative to dacryocystorhinostomy (DCR) in elderly patients. To Aim: determine the surgical outcome of DCT in elderly patients >65 years attending the Department of Ophthalmology, Government Medical College, Srinagar. This was a hospital based prospective study conducted on 35 pat Methods: ients over a period of 2 years from January 2019 to January 2021. Elderly patients >65 years age with presenting complaint of recurrent dacryocystitis, dry eye with no epiphora despite complete nasolacrimal duct obstruction were included in the study. Proper preoperative history was taken with regard to presenting complaints and detailed medical history was recorded. Dry eye was diagnosed using Schirmer-I test and tear lm break-up time. Nasolacrimal duct obstruction was diagnosed by uorescein dye disappearance test and lacrimal irrigation (syringing). Clinical examination was done using slit lamp. Results: In our study, mean age of study population was 75±3 years. Majority of patients were females accounting for 65.7% cases. Main indication of DCT in our study was chronic dacryocystitis accounting for 68.6% cases followed by episodes of acute dacryocystitis in 20% cases and irreducible lacrimal sac swelling accounting for 11.4% cases. Overall surgical outcome was good in our study population with no postoperative complaints at the end of 3 months follow-up in 94.3% cases. Our study indicated that Conclusion: majority of patients who underwent DCT were female with chronic dacryocystitis being the main indication for DCT. DCT is a useful and safe surgical alternative to DCR in elderly patients with recurrent dacryocystitis and in those with underlying systemic comorbidities in whom DCR is associated with a high risk of intraoperative and postoperative complications.