A lacrimal sac abscess incision and drainage technique

A comfortable, anatomically based lacrimal sac abscess incision and drainage technique is described. The records of 52 patients were reviewed. The procedure was relieving and well tolerated because of adequate infraorbital and anterior ethmoidal nerve blocks. To promote rapid resolution, both components of the abscess were drained: the distended lacrimal sac and its associated submuscular pocket. The contiguous cavities were packed and allowed to heal by secondary intention. Of 49 cases, 39 (79.6%) were done as outpatient procedures and 41 (83.7%) were performed under locoregional anesthesia. Edema completely resolved by a median of 7 days. A repeat drainage procedure within 1 month was required in only 4 of 48 cases (8.3%). Fistulas and ectropion were not found. Four of 16 patients (25.0%) who did not eventually receive a definitive procedure (dacryocystorhinostomy or dacryocystectomy) developed a recurrent lacrimal sac abscess after complete resolution of the primary episode.