Meireles Mariana N, Viveiros Magda Mh, Meneghin Roberta Lfs, Galindo-Ferreiro Alicia, Marques Mariângela Ea, Schellini Silvana A
a Department of Ophthalmology , Botucatu Medical School - UNESP , São Paulo , Brazil.
b King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia.
Orbit. 2017 Dec;36(6):419-421. doi: 10.1080/01676830.2017.1353111. Epub 2017 Aug 17.
To evaluate the dacryocystectomy (DCT) outcomes for chronic dacryocystitis in an elderly population over 70 years old. A retrospective chart review was performed for patients over 70 years old who were diagnosed with chronic dacryocystitis and underwent DCT at the Botucatu School of Medicine, UNESP, Brazil, from 2007 to July 2014. Data were collected about patient demographics, age, gender, previous nasal, or ophthalmic diseases, symptoms related to the lacrimal drainage system preoperatively and postoperatively, signs of enlargement of the lacrimal sac (regurgitation of secretion), and histopathologic evaluation. The study sample was comprised of 17 patients with an average age of 76.5 ± 8.5 years. The major complaint for all patients was tearing and 17.6% patients had an additional complaint of discharge. Regurgitation of secretion with lacrimal sac expression was present in 76.5% of patients. Postoperatively, 76.5% of the patients reported improvement of the initial complaint, likely due to the total excision of the lacrimal sac which removed the focal site of chronic infection. Epiphora persisted in 23.5% of patients, of whom 11.7% underwent successful lacrimal stent intubation. DCT for chronic dacryocystitis should be considered a primary procedure in individuals over 70 years old. This procedure has a much lower risk to these patients who often have associated comorbidities.
评估70岁以上老年人群慢性泪囊炎行泪囊摘除术（DCT）的效果。对2007年至2014年7月期间在巴西圣保罗州立大学博图卡图医学院被诊断为慢性泪囊炎并接受DCT的70岁以上患者进行回顾性病历审查。收集了患者的人口统计学数据、年龄、性别、既往鼻部或眼科疾病、术前和术后与泪道引流系统相关的症状、泪囊增大的体征（分泌物反流）以及组织病理学评估资料。研究样本包括17例患者，平均年龄为76.5±8.5岁。所有患者的主要主诉为流泪，17.6%的患者还有溢液主诉。76.5%的患者存在泪囊挤压时分泌物反流。术后，76.5%的患者报告初始主诉有所改善，这可能是由于泪囊的完全切除消除了慢性感染的病灶部位。23.5%的患者仍有溢泪，其中11.7%的患者泪道支架植入成功。对于70岁以上的个体，慢性泪囊炎的DCT应被视为主要手术。该手术对于这些常伴有合并症的患者风险要低得多。
