Immediate endoscopic-DCR tied to faster disease resolution in dacryocystitis: Study

The study is published in The Larnygoscope.

Bo Yu and colleagues from the Department of Orbital and Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China carried out the present study with the objective to compare the results of immediate endoscopic dacryocystorhinostomy (En-DCR) and delayed En-DCR in the treatment of new-onset acute dacryocystitis (AD).

The authors carried out a prospective randomized controlled interventional case series with 176 adults presenting at a tertiary eye care center with new-onset AD manifesting within the last 48 hours, all of whom were randomized into two groups.

Altogether, 160 patients (48 male, 112 female) were included in this study, with a median age of 52.8 years (range: 18–82). Patients in group A underwent urgent En-DCR, although those in group B underwent a delayed En-DCR after 2 to 5 days of systematic antibiotic treatment.

Variables compared between these two groups included the time for resolution of acute external inflammation, free lacrimal passage reconstruction (LPR) success rates, and complication rates.

The key findings of the study were-

a. Postoperative data were collected from 86 patients in group A and 74 patients in group B.

b. Patients that underwent immediate En-DCR exhibited a quicker resolution of acute inflammation (P < .05).

c. Patients that underwent delayed surgery experienced compilations of acute inflammation, with 10 ultimately developing skin fistulization and 4 exhibiting orbital cellulitis before surgery.

d. The success rate of LPR at 12 months after surgery was higher in group A (81/86 94.2%) relative to group B (62/74 83.8%; P < .05).

Hence, the authors concluded that "immediate En-DCR is associated with quicker disease resolution and a higher long-term success rate, although reducing the incidence of complications including skin fistulization and the spread of infection."