J Korean Ophthalmol Soc.  2011 Apr;52(4):385-391.

Clinical Correlation of Lacrimal Sac Pathologic Findings of Lacrimal Sac from Dacryocystorhinostomy

• Jeong WJ
• Hur MC
• Roh MS
• Ahn HB

Abstract

PURPOSE
To determine the correlation of the clinical characteristics and histopathologic findings of lacrimal sac after external dacyrocystorhinostomy (DCR).
METHODS
From March 2008 to June 2009, 49 lacrimal sac tissues of 47 patients were obtained after external DCR and divided according to fibrosis and inflammatory findings. The correlation of preoperative duration of symptoms with NLD obstruction, symptoms of recurrence and outcomes of the operation to the histopathologic findings were retrospectively evaluated.
RESULTS
The mean age of the patients was 58.83 +/- 11.49 years and the mean duration of preoperative symptoms was 65.2 +/- 69.05 months. Forty-three cases (88%) maintained good openings and 30 cases (61%) had no recurring symptoms over 6 months after the operation. Among the significant symptoms, severe subepithelial inflammations were observed more frequently at shorter duration. However, the fibrosis showed a positive relation with the preoperative duration of symptoms (Spearman correlation test, p<0.05). Most failures were found in the severe inflammation and fibrosis groups and were recovered with anti-inflammatory treatment.
CONCLUSIONS
Inflammation and fibrosis of the lacrimal sac could be an important prognostic and predictive factor of outcomes of DCR.

Keyword

Dacryocystorhinostomy; Fibrosis; Inflammation; Lacrimal sac histopathology

MeSH Terms

Dacryocystorhinostomy
Fibrosis
Humans
Inflammation
Recurrence
Retrospective Studies

Figure

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  Figure 1. Histopathologic features of inflammation of lacrimal sac. (A) Mild: mild imflammatory change with loose lymphocyte ag-gregation on submucosal epithelium was found. (B) Moderated: inflammatory cell was concentrated on superior 1/2 submucosa of lacrmal sac. (C) Severe: marked inflammatory cell infiltration (mostly lymphocyte) was found all depth of submucosal epithelium (Hematoxylin & Eosin stain, ×200).

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  Figure 2. Histopathologic findings of fibrosis of lacrimal sac. (A) Mild: loose fibrotic change was found on superficial submucosal epithelium. (B) Moderate: relatively thick fibrotic bundle was distributed on lacrimal submucosa. (C) Severe: dense and thick fibrosis and scarring was found (Hematoxylin & Eosin stain, ×200).

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  Figure 3. Correlation analysis of the grade of inflammation for preoperative duration of symptoms (Spearman correlation, r=-0.520, p=0.001).

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  Figure 4. Correlation analysis of the grade of fibrosis for preoperative duration of symptoms (Spearman correlation, r= 0.366, p=0.010).

Reference

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