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Conservative management of congenital dacryocystocele: resolution and complications

Min Joung Lee1, Jinku Park2, Namju Kim3

  • 1Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang, Korea.

Canadian Journal of Ophthalmology. Journal Canadien D'Ophtalmologie
|July 31, 2019
PubMed

Insights

Conservative management, including lacrimal sac massage, is effective for most infant congenital dacryocystocele cases. Infected cases require antibiotics and sometimes drainage but can also be managed conservatively after infection resolution.

Area of Science:

  • Ophthalmology
  • Pediatric Medicine
  • Neonatology

Background:

  • Congenital dacryocystocele is a common condition in infants.
  • Early intervention is crucial for optimal outcomes.
  • Conservative management is often the first line of treatment.

Purpose of the Study:

  • To evaluate the clinical outcomes of initial conservative management for congenital dacryocystocele in infants.
  • To determine the success rates of conservative treatment and the incidence of complications.
  • To analyze the effectiveness of lacrimal sac massage and identify factors influencing resolution.

Main Methods:

  • Retrospective case series of 30 congenital dacryocystoceles in 28 Korean infants (2006-2015).
  • All infants received conservative management with lacrimal sac massage.
  • Clinical courses, outcomes, resolution rates, and dacryocystitis development were analyzed.

Main Results:

  • Spontaneous resolution occurred in 74.1% of 27 uninfected dacryocystoceles with conservative treatment (mean duration 27.5 days).
  • Lacrimal probing was required for 18.5% of persistent cases.
  • Infectious dacryocystitis developed in 7.4% of uninfected cases and 3 cases presented with infection; 5 cases total had infection requiring antibiotics and sometimes drainage.

Conclusions:

  • Initial conservative management with lacrimal sac massage is highly effective for most uninfected congenital dacryocystoceles.
  • Infected dacryocystoceles necessitate prompt systemic antibiotics and occasionally external drainage for successful conservative management.
  • Conservative approaches are generally successful, with surgical intervention reserved for persistent or complicated cases.
Abstract

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