Search

Utilization of antibiotics for endoscopic dacryocystorhinostomy (endo-DCR) is largely dependent on individual surgeon preference. This study aimed to investigate prescribing practices of pre-, peri-, and postoperative antibiotics and effects on postoperative infection rates in patients who underwent endo-DCR. A retrospective chart review of institutional data at two academic centers of endo-DCR cases from 2015–2020 was performed. Postoperative infection rates for patients who received pre-, peri-, and postoperative antibiotics, individually or in combination, and those who did not, were compared via odds ratio and ANOVA linear regression. 331 endo-DCR cases were included; 22 cases (6.6%) had a postoperative infection. There was no significant difference in the infection rates between patients without an active preoperative dacryocystitis who received different permutations of peri- and postoperative antibiotics. Patients who received preoperative antibiotics within two weeks of surgery for preexisting acute dacryocystitis, but did not receive peri- or postoperative antibiotics, had a higher rate of postoperative infections (p = 008). Our data suggest antibiotics may be beneficial only when patients have a recent or active dacryocystitis prior to surgery. Otherwise, our data do not support the routine use of antibiotic prophylaxis in endo-DCR. [ABSTRACT FROM AUTHOR]

Objective: There is value in understanding the common etiologies of epiphora within different patient populations as well as identifying barriers to adequate treatment and symptom relief. The primary goal of the study is to report common etiologies of epiphora and the impact of treatment in patients of a large, inner-city hospital. Methods: This is a retrospective review of 10 years of data from the charts of 516 adult patients. The most common diagnoses and interventions linked to this symptom were evaluated. Subjective symptom improvement and adherence to follow-up were also analyzed. Results: Three hundred (58.1%) patients carried a diagnosis of dry eye syndrome and, of these, 40.1% did not have other ocular findings to explain their epiphora. Conservative management (CM) was recommended to the majority (86.4%) of the study population. 27.5% of the 357 patients who received CM as the only intervention reported symptom improvement. 90.1% of patients who underwent DCR reported symptom improvement. Nearly half of the patients were lost to follow-up. Conclusion: Epiphora is a common symptom that may be multifactorial in etiology, making effective treatment a challenge. Reflex tearing secondary to ocular surface dryness was the most common etiology linked to epiphora in this study. Low rates of follow-up limit the ability to fully assess the impact of current interventions on symptoms. Addressing the socioeconomic barriers that lower patient adherence to follow-up should allow more effective treatment of epiphora. [ABSTRACT FROM AUTHOR]