Recurrent Dacryocystitis Research Articles

Lacrimal sac dacryolith treated with endoscopic dacryocystorhinostomy: A case report and literature review

Dacryolith is a concretion within the nasolacrimal systemthat may calcify and cause further obstruction of the nasolacrimal pathway. It may cause intermittent epiphora without inflammation or recurrent dacryocystitis and is often diagnosed during dacryocystorhinostomy (DCR). We report the case of a lacrimal sac dacryolith in a 37-year-old man who was referred to our hospital from the eye clinic with complaints of epiphora that were not relieved by medication. He had no history of epiphora. During endoscopic DCR, the presence of dacryolith in the lacrimal sac was detected and completely removed while the pus was drained. The patient was discharged on the second postoperative day with systemic and topical antibiotics. During routine follow-up, the patient was in good condition and had no complaints. We aim to raise awareness among clinicians of this unusual cause of nasolacrimal duct obstruction, which can be successfully managed with endoscopic DCR rather than an open external approach.

Outcomes of Endoscopic Endonasal Dacryocystorhinostomy in Glaucoma Patients.

Anti-glaucoma eye drops have been investigated due to their production of fibrotic changes on the conjunctival surface, undermining the functioning of the upper lacrimal drainage system. We aimed to assess whether these effects may impair the effectiveness of endoscopic endonasal dacryocystorhinostomy (EE-DCR). This is a single-center observational retrospective study on EE-DCR via a posterior approach. Resolution of epiphora and dacryocystitis were analyzed after 1 (T1) and 6-months (T2) from surgery. Surgical success was defined as anatomical (patency at irrigation, no recurring dacryocystitis) or complete (zeroing of Munk score). Twenty patients (32 sides) were enrolled. Preoperatively, 93.75% (n = 30/32) presented severe (Munk 3-4) epiphora and 68.75% (n = 22/32) recurrent dacryocystitis. At T1, 50.0% (n = 16/32) were referred with residual epiphora (Munk ≥ 1) and 18.75% (n = 6/32) dacryocystitis. At T2, 31.25% (n = 10/32) still complained of epiphora (Munk ≥ 1) and 6.25% (n = 2/32) dacryocystitis. Difference of outcomes at aggregate and paired timepoints (except for T1 versus T2) resulted in statistical significance (p < 0.05). At T2, 22 (68.75%) complete, 8 (25.0%) anatomical successes and 2 (6.25%) surgical failures were observed. Despite the chronic uptake of anti-glaucoma eye drops, EE-DCR guaranteed high rates of clinical relief from epiphora and remarkable decreases in the rates of recurrent dacryocystitis.

Prevotella Denticola Dacryocystitis and Abscess in a Child with Goldenhar Syndrome

Dacryocystitis is the inflammation of the nasolacrimal sac and is due to obstruction of the nasolacrimal system or lacrimal stagnation, leading to favorable environments for infection. Any disruptions to the nasolacrimal pathway can increase the risk of dacryocystitis. Here is a unique case of Prevotella denticola dacryocystitis that progressed into cellulitis and abscess formation in a 7-year-old female with a medical history of Goldenhar syndrome, recurrent dacryocystitis, and periodontal disease. The patient presented with standard dacryocystitis symptoms—tenderness to palpation, erythema, and edema to the medial canthus. The patient was treated empirically with vancomycin, ceftriaxone, and clindamycin. She was discharged home on clindamycin with symptomatic improvement and plans for dacryocystorhinostomy. Goldenhar syndrome is a rare congenital craniofacial malformation disorder due to aberrant morphogenesis in structures derived from the first and second branchial arches. P. denticola is an anaerobic gram-negative bacillus significant to the oral microbiome. There is currently limited research suggesting the relationship between Goldenhar syndrome and dacryocystitis complicated by Prevotella denticola. Based on the patient’s medical history, we predict that her complex presentation was secondary to the dissemination of Prevotella from her oral cavity. This case report emphasizes the importance of gram-negative anaerobic coverage in complicated dacryocystitis in patients with nasolacrimal defects.

Outcomes of Endoscopic Endonasal Dacryocystorhinostomy in Glaucoma Patients

Purpose: Glaucoma has been investigated on producing fibrotic changes on the conjunctival surface, undermining the functioning of the upper lacrimal drainage system. The aim of the study was to assess whether these effects may impair the effectiveness of dacryocystorhinostomy (DCR) in patients affected by both glaucoma and nasolacrimal duct obstructions (NLDO). Methods: Single-center observational retrospective study on endoscopic endonasal-DCR (EE-DCR) via posterior approach. Consecutive patients were enrolled in 2020–2023 and evaluated with proper questionnaires; resolution of epiphora and dacryocystitis were analyzed after 1 (T1) and 6-months (T2) from surgery. Surgical success was defined as anatomical (patency at irrigation, no recurring dacryocystitis) or complete (zeroing of Munk score). Results: 17 patients (29 operated sides) were enrolled. Preoperatively, 92.1% (n = 27/29) presented severe (Munk 3-4) epiphora and 69.0% (n = 20/29) recurrent dacryocystitis. At T1, 51.72% (n = 15/29) referred residual epiphora (Munk  1) and 17.20% (n = 5/29) dacryocystitis. At T2, 34.5% (n = 10/29) still complained epiphora (Munk  1) and 6.9% (n = 2/29) symptoms of dacryocystitis. Difference of outcomes at aggregate and paired timepoints (except for T1 versus T2) resulted statistically significant (p&lt;0.05). At T2, 20 (69.0%) complete, 7 (24.2%) anatomical successes and 2 surgical failures (6.8%) were observed. Conclusion: EE-DCR in patients affected by both glaucoma and NLDO guaranteed high rates of clinical relief from epiphora and remarkable decreases in the rates of recurrent dacryocystitis, appearing as a reasonable therapeutical strategy to improve disease-related quality of life.

Ультразвуковая эндоназальная дакриоцисториностомия в лечении рецидивирующего дакриоцистита новорожденного

Purpose. To evaluate early and long-term functional and anatomic results of surgical treatment of lacrimal pathways obstruction (LPO) in children with endonasal dacryocystorhinostomy (EDCR) method using ultrasound bone tissue dissector for the formation of nasolacrimal anastomosis. Material and methods. Surgical treatment of recurrent dacryocystitis of newborn (DN) after repeated unsuccessful «blind»lacrimal pathways probing in children with nasolacrimal duct obstruction, including cases of congenital nasolacrimal duct atresia. Bone «window» of the nasolacrimal anastomosis during endoscopic EDCR was formed using SONOCA 185 piezoelectric ultrasound dissector. In total, 14 children, 8 girls and 6 boys aged from 3 to 11 years (mean, 6 years) were operated with follow-up period of 6 months. Results. It was found that in all the children an adequate nasolacrimal anastomosis was formed without significant bleeding episodes both intraoperatively and in the early post-op period. No cases of destruction of the medial wall of the lacrimal sac were marked. Functional success was achieved in 92.8% (13 of14 cases). In 7.2% (1 of 14cases) there was a postoperative granuloma of the mucous in the rhinostoma region which was a partial obstacle for tear flow. Conclusions. Controlled low temperature process of nasal bones ultrasound dissection during EDCR in children allows formation of an adequate bone «window»and, therefore, a valuable nasolacrimal anastomosis in narrow nasal passages, makes the surgical procedure much easier and quicker, enables better healing of soft tissues in a shorter period. Key words: recurrent dacryocystitis of newborns, endonasal endoscopic dacryocystorhinostomy, ultrasound dissection of bone tissue

Modified external revision-DCR in previous failed endonasal, transcanalicular or external-DCR: technical strategy and teaching Pearls for success.

Objective: To report perioperative findings of patients with multiple failed-dacryocystorhinostomy (DCR) and to determine the success rate of revision external (rEx-DCR) performed by a modified technique. Methods: Thirty-one eyes of 31 patients (19 women, 12 men) with recurrent dacryocystitis or epiphora following at least one previous failed-DCR were assessed regarding the time from initial surgery to recurrence and revision surgery, type of primary surgery (endoscopic, transcanalicular, Ex-DCR), recurrence number, stent usage and the success rate. Relief of epiphora and positive dye test were established as functional and anatomical successes, respectively. Results: The mean age was 43.0 years (8-78), with a mean follow-up period of 21.4 months (6-46). The mean reoperation number was 1.4 (1-5). The mean time from initial surgery to recurrence was 15.2 months (1-55) and to rEx-DCR, 19.8 months (4-65). Untouched medial canthal ligament was observed in 28 (90.3%), improper rhinostomy location in 26 (83.8%), inadequate osteotomy size in 25 (80.6%), single-anterior-flap-only in 5 (16.1%), membranous ostial scar formation in four (12.5%) and no flap in three (9.6%) patients. The success rate was 93.5%, which was lower than our primary modified Ex-DCR (99.1%). Conclusions: The most common reasons for recurrence were small and unsuitable osteotomy locations with intact medial canthal ligaments. "Double-mucosal flap" approach with an anterior sacco-mucosal complex suspension increases the functional success rate, and stent implantation is not obligatory if canalicular problems or small/ atrophic sacs do not exist. The knowledge of technical strategy and teaching pearls improves the success rates of primary and revision surgeries. Abbreviations: DCR = dacryocystorhinostomy, Ex-DCR = external DCR, EE-DCR = endoscopic endonasal DCR, TC-LA-DCR = transcanalicular laser-assisted DCR.

Idiopathic acquired dacryocystocele in an adult: case report of a rare entity

BackgroundIdiopathic acquired dacryocystocele in adults is a rare disorder of the lacrimal drainage pathway. Only 20 cases have been reported in the literature. It presents with a triad of epiphora, medial canthal swelling, and recurrent dacryocystitis. Patients presenting without recurrent dacryocystitis is quite uncommon. This presentation can be confused with secondary nasolacrimal duct obstruction and other non-inflammatory pathologies. Dacryocystorhinostomy with stenting is the treatment employed in most reported cases.Case presentationA 24-year-old male presented with epiphora and medial canthal swelling for 3 years. Examination revealed features of left nasolacrimal duct obstruction. Imaging was suggestive of a cystic, homogenous, non-enhancing lesion in the left lacrimal sac region without bone destruction. Findings were suggestive of dacryocystocele. Patient underwent endoscopic dacryocystorhinostomy without stenting. Postoperatively, the swelling and epiphora resolved. Patient is symptom-free on follow-up.ConclusionIdiopathic dacryocystocele must be considered in evaluation of a medial canthal mass with epiphora without dacryocystitis. Conservative treatment is ineffective. Endoscopic dacryocystorhinostomy is safe and effective.

Non-contrast MR dacryocystography for the evaluation of epiphora and recurrent dacryocystitis: A preliminary study.

Obstruction of the lacrimal drainage represents a common ophthalmologic issue. The blockage may interest any level of the lacrimal drainage pathway, and it is important to find the site of obstruction to plan the most appropriate treatment. In this study, findings from magnetic resonance (MR) dacryocystography were compared with findings from endoscopic and surgical procedures to evaluate the accuracy of MR dacryocystography in localizing the site of nasolacrimal duct obstruction. We enrolled twenty-one patients with clinical suspicion of nasolacrimal duct obstruction who underwent dacryoendoscopy and surgery. MR dacryocystography was performed with a heavily T2-weighted fast spin echo sequence in the coronal planes. Before the MRI was performed, a sterile 0.9% NaCl solution was administered into both conjunctival sacs. For each examination, two independent readers (with 8 and 10years of experience in head and neck imaging) evaluated both heavily 3D space T2-weighted and STIR sequences. Stenosis/obstruction of nasolacrimal duct or lacrimal sac was diagnosed in all 21 patients who underwent MRI dacryocystography. In particular, the site of the obstruction was classified as lacrimal sac in 12 (57%) patients, nasolacrimal duct in 6 (29%) patients, and canaliculi in 3 (14%) patients by both readers. By comparison with the evidence resulting from the endoscopy, there were differences between MRI dacryocystography and dacryoendoscopy in the evaluation of the obstruction's site in three patients, with an overall accuracy of 85.7%. MR dacryocystography allows a non-invasive evaluation of the lacrimal drainage pathway, valid for the planning of the most appropriate treatment.

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

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 &gt;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 &gt;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.

First-Onset Dacryocystitis: Characterization, Treatment, and Prognosis.

IntroductionTo assess the risk of recurrent dacryocystitis after first-onset dacryocystitis and to obtain a demographic profile and treatment characteristic for patients with first-onset dacryocystitis.MethodsA retrospective study was performed on patients who had first-onset dacryocystitis during the years 2010–2013. Patients were followed up for 3 years. The analysis focused on the recurrence of dacryocystitis, demographics, medical treatment, and choice of lacrimal surgery.ResultsThe inclusion criteria were met by 52 patients. Of these 15 (29%) had one or more recurrence of dacryocystitis, and 18 patients (34.6%) underwent lacrimal surgery. The mean age was 51.6 years (median 55.5, range 0–93). The female-to-male ratio was slightly under 3:1 (73.1%). The most frequent medical treatment was flucloxacillin capsules combined with chloramphenicol eye drops or ointment.ConclusionsThe majority of patients with first-onset dacryocystitis had no further episodes of dacryocystitis. Some patients experienced recurrent and complicated infections requiring surgery and were thus a significant burden on the healthcare services. Various surgical options were used to clear the nasolacrimal obstruction causing dacryocystitis. Dacryocystorhinostomy was the most common procedure and showed excellent success rate.

Treatment of dacryocystorhinostomy and intubation under nasal endoscope on recurrent dacryocystitis after removal of artificial nasolacrimal duct

Treatment of dacryocystorhinostomy and intubation under nasal endoscope on recurrent dacryocystitis after removal of artificial nasolacrimal duct

First results of endonasal balloon dacryoplasty use in recurrence after dacryocystorhinostomy

Background. In recurrent dacryocystitis after dacryocystorhinostomy, a re-operation is indicated. In recent years, some publications appeared concerning endonasal dacryoplasty using 9 mm-balloon in treatment of patients with recurrent dacryocystitis.&#x0D; Purpose to evaluate the possibility of using endonasal balloon dacryoplasty in recurrence after dacryocystorhinostomy.&#x0D; Materials and methods. Into the study, 6 patients (6 cases) were included who underwent endonasal endoscopic dacryocystorhinostomy for dacryocystitis 1-3 years before. In all patients, evaluation of Munks scores for epiphora, optical coherence tomography (OCT) based lacrimal meniscometry, dye disappearance test, lacrimal drainage system syringing and probing of its horizontal part, nasal endoscopy, multispiral computed tomography of lacrimal drainage system with contrast enhancement. In all patients, endonasal dacryoplasty using a balloon with 6 mm diameter was carried out. The follow-up period after surgery was 6 months.&#x0D; Results. In 4 patients, recovery was achieved, in 1 patient improvement was obtained, in 1 patient there was dacryostoma cicatrization.&#x0D; Conclusion. Preliminary results received in this study of the balloon dacryoplasty performed in 6 patients afford ground to consider it possible to use this method in patients with dacryocystitis recurrence after dacryocystorhinostomy. The matter of the prospects when using this method may be solved after further research aimed to increase the number of clinical observations to enhance the possibility of adequate statistical processing of obtained results, to extend the postoperative follow-up period, to develop the indications for this procedure, and to investigate the necessity in additional manipulations improving the effectiveness of endonasal balloon dacryoplasty.

Is Stenting Really Necessary in Primary Endonasal DCR-Our Experience.

To Know the relevance of silicone intubation in Endoscopic DCR. A prospective randomized controlled trial study was conducted in the Department of ENT at Dr. Babasaheb Ambedkar Memorial Central Railway Hospital, Byculla, Mumbai. Duration of study was from March 2015 to November 2018. 100 patients in the age group ranging from 20 to 70years, with acquired Nasolacrimal duct obstruction with epiphora and recurrent dacryocystitis were evaluated and managed. These patients were randomized into two groups based on using table of random numbers into two Group A: DCR without stent (n = 50) and Group B: DCR with stent (n = 50). Every patient was subjected to detailed history and examination. The overall success rate in our study with silicone stent was 92% and without stent was 88%. There was no statistically significant (p > 0.05) difference between the two groups. According to our experience silicone stent is really not needed in Endoscopic DCR and if at all used it should be used up to 7days to prevent restenosis and to prevent mucosal flaps to cover stoma again. Use of silicone stent should be restricted to following cases like post traumatic, revision, fibrosed small contracted sac and suspected canalicular block cases.

Dacryocystectomy with Lacrimal Silicone Intubation in Challenging Patients Affected by Recurrent Dacryocystitis and Epiphora: Expanding Minimally Invasive Approach Indications

Objective:In this study, we evaluated the feasibility and safety of dacryocystectomy associated with lacrimal intubation, for the treatment of recurrent dacryocystitis and epiphora secondary to lacrimal obstruction with compromised lacrimal sac, was evaluated.Subjects and Methods:32 patients underwent dacryocystectomy with Crawford tubes canalicular insertion, performed by a single surgeon. Post-operative visits were scheduled at 1stand 10th day, 1, 3, and 6 months. At each follow-up visit, the prevalence of epiphora and dacryocystitis was evaluated and compared with baseline data. Also, we evaluated the prevalence of local and systemic post-operative adverse events during the follow-up period.Results:11 patients (34.38%) reported persistent epiphora, which lasted for 30 days after surgery. Among them, 9 subjects (28.13%) complained occasional epiphora even at the six months follow-up. In the event of dacryocystitis or subacute phlogosis before surgery, patients reported a definitive symptom resolution. Other reported adverse events were epithelial corneal erosion due to Crawford tube protrusion (4 cases, 12.5%), a Crawford tube extrusion case (3.13%), 3 cases of surgical wound dehiscence (9.36%), and a case of mild local bleeding persisting for 15 daysConclusion:A significative epiphora reduction was observed after surgery with an acceptable safety profile, expanding dacryocystectomy indications. This procedure provides a satisfactory resolution of recurrent dacryocystitis. However, this approach should be performed only in well-selected cases: elderly/frail patients with altered lacrimal sacs, epiphora associated with recurrent infections, and failure after dacryocystectomy.

Dacryocystectomy as a treatment alternative for chronic recurrent dacryocystitis in elderly patients: case series study

Dacryocystectomy is a procedure that involves complete surgical extirpation of the lacrimal sac. It was first described by Woolhouse in 1724 and became the gold standard for the management of lacrimal system obstruction and dacryocystitis before the advent of dacryocystectomy. Many minimally invasive methods are currently available to treat lacrimal disorders, but there are several specific indications for dacryocystectomy, such as malignant lacrimal sac tumors.&#x0D; Generally, the procedure is performed under local anesthesia, which avoids risks that are associated with general anesthesia or sedation in ailing or elderly patients. Dacryocystectomy can also also avoid skin scars. In 2013, Shams and Selva were the first to perform endoscopic dacryocystectomy.&#x0D; This article discusses indications, contraindications, goals, techniques, and complications of dacryocystectomy.

Balloon dacryoplasty in the treatment of recurrent dacryocystitis

Causes of the recurrence after dacryocystorhinostomy are errors during surgery (small size of the bone window, wrong localization of the dacryostomy (too high or too low); inadequate formation of flaps at the medial wall of the lacrimal sac and at the mucosa of the nasal cavity) or problems occurring in the follow-up period (granulation in ostium area, synechiae between the structures of the nasal cavity near the dacryostomy, canaliculi ostium obliteration). A literature review considers various methods of dacryocystitis recurrence treatment both with external and endonasal approaches. In published studies, promising results were obtained using balloon dacryoplasty in the dacryostomy area after dacryocystitis relapse.

Infantile Endoscopic Dacryocystorhinostomy: Indications, Anatomical Considerations, and Outcomes

The purpose of this case series is to report the demographic profile, indications, anatomical considerations, and outcomes of Endonasal endoscopic DCR in the infants. Five eyes of 3 infants underwent IEnDCR with a mean age of 4.26 months (range: 23 days-8 months). There were 2 males and 1 female. Two of the infants underwent bilateral surgery. The indication for surgery in the infant undergoing unilateral surgery was recurrent acute dacryocystitis and lacrimal abscess formation secondary to refractory and complex congenital nasolacrimal duct obstruction. Infants undergoing bilateral lacrimal surgery had refractory complex congenital nasolacrimal duct obstruction and were in need for an early intraocular surgery for associated ocular morbidities. Mitomycin-C (0.02% for 3 minutes) and silicone intubation was used in all cases. At follow up of 9 months, all the 3 infants demonstrated anatomical and functional success. The surgical technique requires certain modifications in order to cater to the unique challenges. It is safe and effective in experienced hands and can be considered as an alternative to an external DCR in infants.

Congenital Lacrimal Fistula in a Seven-Year-Old Female: A Rare Cause of Epiphora

Congenital lacrimal fistulas are rare epithelium-lined tracts that tend to have a direct communication between skin and the lacrimal drainage system. These are benign developmental abnormalities, that may require no treatment. This is a rare diagnosis since patients are usually asymptomatic and presents only when epiphora is associated. When symptomatic, congenital lacrimal fistula presents as epiphora, or mucoid discharge, rarely patients could develop nasolacrimal duct obstruction, which may present as recurrent dacryocystitis. Thorough clinical examination is the best way to diagnose the condition, where a fistula ostium may be found inferonasal to medial canthus of the eye. Further, lacrimal probing and irrigation is helpful. Surgical management of the fistula is advised only if the disease is symptomatic which ranges from simple excision to dacryocystorhinostomy. This is a report of one such patient with congenital lacrimal fistula which was treated surgically by fistulectomy.

Ciało obce w woreczku łzowym – opis przypadku

A 78-year-old woman was admitted to the ophthalmology department for removal of a soft, painless raised lesion in the region of her left lacrimal sac. The lesion had been observed for several months. MRI images showed a cyst connected to the lacrimal sac. The patient's medical history revealed she had suffered from excessive tearing for 3 years and recurrent dacryocystitis. During the procedure of cyst removal, after tissue preparation the lesion appeared as an inflamed lacrimal sac with the old stenting material inside.

Собственный опыт профилактики рецидивов дакриоцистита при наружной дакриоцисториностомии

Purpose: to evaluate the effectiveness of integrated methods of prevention dacryocystitis recurrences in external dacryocystorhinostomy. Materials and methods. 120 patients (120 eyes) with dacryocystitis, 85 women and 35 men, aged 21 to 75, were divided into 2 groups. The main group of 60 patients (60 eyes, 40 women and 20 men) whose mean age was 65 ± 12.5 years were subjected to external dacryocystorhinostomy with the use of a specially modified device, trepanation fraise, for the formation of the bone window and a binary stent to ensure the tamponade of a formed anastomosis. The control group was formed by the remaining 60 patients (60 eyes, 45 women and 15 men) with a mean age of 69 ± 16.2 years, who underwent regular operations according to Addeo Toti. Results. In the main group, recuperation was noted in 49 cases (82 %) and improvement in 10 cases (17 %). 1 case (1.6 %) showed a recurrent dacryocystitis. In the control group, recuperation was achieved in 38 cases (63.3 %), improvement in 17 cases (28.3 %) and the recurrence of the condition occurred in 5 cases (8.3 %). Conclusion. The proposed method enables an effectiveness increase of external dacryocystorhinostomy surgeries. For citation: Shikhunov D.Sh., Aliev A-G.D., Aliev A.A.-G., Abdulaev A.B.. The experience of prevention of dacryocystitis recurrences in external dacryocystorhinostomy. Russian ophthalmological journal. 2018; 11 (1): 30-4. doi: 10.21516/2072-0076-2018-11-1-30-34 (In Russian).