Endoscopic dacryocystorhinostomy in patients taking aspirin perioperatively

The aim of this study is to report the results of endoscopic dacryocystorhinotomy (EDCR) in patients who did not interrupt their low-dose (75-150 mg daily) aspirin regimen for the procedure.

A case note review was made of all 40 patients taking aspirin who had EDCR at Ipswich Hospital from May 1998 to October 2003. Age, gender, indications for surgery, complications, and outcome were analyzed and the bleeding rate compared to that in patients who were not on aspirin or warfarin who had an EDCR.

Of the 51 EDCRs performed in the 40 patients, 47 had complete relief of epiphora. Two of the patients with a persistent watering eye are to have revision surgery, 1 patient was observed (75% improvement), and 1 patient has since died. A total of 33 patients had no postoperative complications; 5 had epistaxis but only 1 of these required a nasal pack; 1 each had minor periorbital bruising, confusion, and facial pain, none of which delayed discharge. None required readmission. Of 257 EDCRs in patients not on aspirin or warfarin, 1.3% had epistaxis resulting in delayed discharged or readmission.

EDCR is a safe and efficacious treatment in patients with distal nasolacrimal obstruction in patients taking aspirin and does not require stopping the aspirin perioperatively.