98th Annual Meeting DOG 2000

V 382

Indication and results of dacryocystorhinostomy in the pediatric population – a clinical presentation from 1970 - 2000

H. G. Struck, R. Weidlich

Background: Dacryocystitis in infants is a serious complication of the congenital - seldom of the acquired - nasolacrimal duct obstruction. If conservative treatment fails dacryocystorhinostomy (DCR) appears to be effective. The indication, special clinical history and results should be reviewed.

Patients and methods: From 1/1970 to 2/2000 72 children (56 were male, 16 were female) with persistent dacryocystitis (18 bilateral) were treated surgically by DCR and were documented consecutively. The patients ranged in age from 10 (7) months to 14 years (mean age of 4.9 years). Included in our study were 66 children (52 were male, 14 were female) with 84 surgically treated lacrimal pathways (46 right eyes, 38 left eyes) who underwent control examination.

Results: The cause of dacryocystitis was congenital obstruction in 63 children and a trauma (maxillary fracture) in 3 children, respectively. 20 children (30.3%) had additional anomalies of the lacrimal system and 20 (30.3%) systemic malformations, respectively. 8 of 66 children (12.1%) had a familiar history of nasolacrimal duct obstruction. Since 1985 the surgical procedures were performed under microsurgical conditions and since 1998 sometimes with transcanalicular laser-assisted technique. We found a functional success rate (with complete resolution of symptoms) of 90.4%

(76 of 84 lacrimal pathways) with a follow up period of 1 month to 12 years (on average 1.6 years).

Conclusion: Patients with persistent dacryocystitis due to congenital nasolacrimal duct obstruction have a prevalence of further nasolacrimal abnormalities and a familiar history. The dacryocystorhinostomy of infants requires minimal invasive (sometimes laser-assisted) techniques. In the case of persistent dacryocystitis DCR is indicated after the age of one year and has the same success rate in infants as in adults (90 - 95%).

Department of Ophthalmology, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06097 Halle/Saale