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Bacteriology of lacrimal duct obstruction in adults
J Hartikainen1, O P Lehtonen, K M Saari
1Department of Ophthalmology, Turku University Central Hospital, Finland.
Aims:
To determine the current bacteriology of lacrimal duct obstruction (LDO) and to relate the bacteriological findings to the type of symptoms.
Methods:
127 samples were obtained from the lacrimal sac in 118 consecutive adult patients with LDO, including nine bilateral cases.
Results:
Altogether, 156 isolates were recovered from the 127 samples cultured. Cultures were positive from 84% of the samples. Gram positive bacteria were isolated in 79 (62%) samples. The most frequently cultured bacterial species was Staphylococcus epidermidis, representing 27% of the isolates. Gram negative bacteria were recovered from 26 (20%) samples, and these bacteria were statistically significantly more common in cases with copious discharge than in cases with minor discharge (p = 0.000). Cases with simple stenosis of the lacrimal duct (SSLD) showed significantly less Streptococcus sp (p = 0.004) and Gram negative organisms (p = 0.004) than those with chronic dacryocystitis.
Conclusion:
The bacteriology of SSLD resembles that of normal conjunctival flora. Chronic dacryocystitis in adults is associated with an increased proportion of Gram negative bacteria which may be a reservoir for postoperative intraocular infection. They should also be taken into account in selecting antimicrobial prophylaxis in lacrimal drainage surgery.