Clinical analysis of 338 cases of dacryolithiasis

Dacryolithiasis can occur anywhere in the lacrimal drainage system and is frequently associated with microbial infections. The presence of dacryolithiasis is difficult to determine based on its clinical manifestations, which complicates clinical treatment.

To analyze the clinical diagnosis, treatment and characteristics of dacryolithiasis, as well as surgical methods used to treat it and treatment effects over the past 5 years.

A retrospective analysis was performed on the clinical data of 338 patients who were diagnosed with dacryolithiasis at our hospital from January 2017 to December 2021. Patients diagnosed with canaliculitis were treated with canaliculotomy. Dacryocystitis complicated by canaliculitis was treated with endoscopic dacryocystorhinostomy (En-DCR) combined with canaliculotomy. Dacryocystitis accompanied by dacryoliths was treated with En-DCR. Nasolacrimal duct stones were treated with lacrimal intubation. All patients were followed up for 6-12 months.

All patients underwent successful surgery. Of 302 cases (89.35%) with canaliculitis, 297 (98.34%) were cured with canaliculotomy; 5 cases (1.66%) recurred within 1 year after surgery and were cured with canaliculotomy again. Four cases (1.18%) of dacryocystitis complicated by canaliculitis were treated with En-DCR combined with canaliculotomy. In addition, 30 patients (8.88%) had dacryolithiasis; 28 (93.33%) of them were cured, and 2 (6.67%) with common canalicular atresia were cured after lacrimal intubation. Furthermore, 2 patients (0.59%) with nasolacrimal duct stones underwent lacrimal intubation. In addition, 62 cases (20.53%) with canaliculitis tested positive for bacteria, and the top 2 common bacteria were Staphylococcus epidermidis and Streptococcus mitis.

Secretions are the main clinical characteristic of patients with dacryolithiasis, and surgery is the primary treatment method. In addition, different surgical methods correspond to different locations of stones.