Clinicopathologic analysis of 166 patients with primary acquired nasolacrimal duct obstruction

Ophthalmology. 2001 Nov;108(11):2038-40. doi: 10.1016/s0161-6420(01)00783-7.


Objective: To determine the prevalence of lacrimal sac pathology in patients undergoing dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (PANDO).

Design: Observational case series.

Participants: One hundred sixty-six patients with symptoms of PANDO.

Methods: A total of 202 lacrimal sac biopsies were obtained from 166 patients undergoing external DCR procedures for symptoms of PANDO.

Main outcome measures: Patient demographics, presenting symptoms and signs, relevant history, and assessment of the nasolacrimal system were recorded. All lacrimal biopsy specimens were examined histopathologically.

Results: A total of 118 patients (71%) were female and 48 patients (29%) were male. The mean age was 60.7 years (range, 21-93 years). All patients demonstrated epiphora, and 32 patients had dacryocystitis. Duration of symptoms ranged from 6 weeks to 50 years. No lacrimal sac tumors were detected. Sixty-five percent of specimens demonstrated chronic inflammation.

Conclusions: No neoplasms were detected among 202 lacrimal sac specimens from 166 patients with symptoms of PANDO. Most lacrimal sac specimens demonstrated chronic inflammatory changes. We conclude that a lacrimal sac biopsy should be performed when there is suspicion of a neoplasm based on the clinical, historical, or intraoperative findings, rather than routine biopsy of all patients with PANDO.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Dacryocystorhinostomy
  • Female
  • Humans
  • Lacrimal Duct Obstruction / pathology*
  • Male
  • Middle Aged
  • Nasolacrimal Duct / pathology*
  • Nasolacrimal Duct / surgery
  • Prevalence