Dacryocystectomy: indications and results

BACKGROUND: After the advent of dacryocystorhinostomy (DCR), dacryocystectomy (DCT) was regarded as mutilant surgery and reserved for lacrimal sac tumors. PURPOSE: To present current indications for dacryocystectomy. METHODS: Eighteen eyes from 11 patients subjected to DCT were reviewed retrospectively. Nine patients had chronic dacryocystitis confirmed by dacryocystography and two patients had lacrimal sac tumors. RESULTS: The indications for DCT were: three patients with systemic medical problems, three patients with dry eye, two cases of lacrimal sac tumors, two cases of traumatic dacryocystitis and one case of cutaneous leishmaniasis. Dacryocystitis was resolved in 17 of 18 eyes; the two cases of tumor evolved without epiphora. One patient (traumatic dacryocystitis) had recurrence of dacryocystitis. CONCLUSIONS: DCT is mainly performed when a lacrimal sac tumor is suspected but, since it avoids the intra- and postoperative complications related to dacryocystorhinostomy, it can be indicated in cases of dacryocystitis with significant lacrimal discharge and an enlarged or altered lacrimal sac.