Related Experiment Videos
Clinicopathologic analysis of 166 patients with primary acquired nasolacrimal duct obstruction
1Department of Ophthalmology, University of Calgary, Calgary, Alberta, Canada.
Objective:
To determine the prevalence of lacrimal sac pathology in patients undergoing dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (PANDO).
Design:
Observational case series.
Participants:
One hundred sixty-six patients with symptoms of PANDO.
Methods:
A total of 202 lacrimal sac biopsies were obtained from 166 patients undergoing external DCR procedures for symptoms of PANDO.
Main Outcome Measures:
Patient demographics, presenting symptoms and signs, relevant history, and assessment of the nasolacrimal system were recorded. All lacrimal biopsy specimens were examined histopathologically.
Results:
A total of 118 patients (71%) were female and 48 patients (29%) were male. The mean age was 60.7 years (range, 21-93 years). All patients demonstrated epiphora, and 32 patients had dacryocystitis. Duration of symptoms ranged from 6 weeks to 50 years. No lacrimal sac tumors were detected. Sixty-five percent of specimens demonstrated chronic inflammation.
Conclusions:
No neoplasms were detected among 202 lacrimal sac specimens from 166 patients with symptoms of PANDO. Most lacrimal sac specimens demonstrated chronic inflammatory changes. We conclude that a lacrimal sac biopsy should be performed when there is suspicion of a neoplasm based on the clinical, historical, or intraoperative findings, rather than routine biopsy of all patients with PANDO.