Endoscopic and radiological evidence refuting intra-abscess septae

Area of Science:

• Ophthalmology
• Oculoplastics
• Medical Imaging

Background:

• Lacrimal sac abscesses are typically managed with incision and drainage.
• The presence of internal septations can complicate management.
• Magnetic Resonance Imaging (MRI) and endoscopic evaluation can assess abscess characteristics.

Purpose of the Study:

• To investigate the presence of septae within lacrimal sac abscesses.
• To evaluate simple aspiration as a minimally invasive alternative to incision and drainage.

Main Methods:

• A prospective pilot study of eight patients with lacrimal sac abscesses.
• Pre-operative MRI and intra-sac endoscopic evaluation were performed.
• Patients were randomized to aspiration (n=4) or incision and drainage (n=4).

Main Results:

• High-resolution MRI revealed well-defined abscess cavities without septae or loculi.
• Endoscopic evaluation correlated MRI findings with edematous mucosal folds.
• All patients achieved symptom relief and anatomical patency post-treatment.

Conclusions:

• The study refutes the presence of septae within lacrimal sac abscesses.
• Simple aspiration is proposed as a safe, minimally invasive, and effective treatment.
• Aspiration offers advantages in terms of logistics and learning curve compared to traditional methods.