Frequency of Nasolacrimal Duct Obstruction in Patients Undergoing Cataract Surgery

One of the most important risk factors for endophthalmitis after cataract surgery is the presence of nasolacrimal duct obstruction (NLDO), which can be diagnosed pre-operatively. Considering the high prevalence of cataract reported in our province, Guilan, we decided to study the incidence of NLDO in a sample of patients, who were candidate for cataract surgery according to irrigation and dye disappearance test (DDT).

This non-randomized longitudinal descriptive study prospectively investigated all patients, who had undergone cataract surgery only in one service in Amiralmomenin Hospital during 2016. All participants underwent complete eye examination, irrigation test, and DDT. Complete history was taken from all patients, particularly the history of tearing of the eyes. The main outcome measure of this study was the frequency of NLDO in a patients undergoing cataract surgery and the secondary outcome was sensitivity and specificity of DDT in a diagnosis of NLDO. The data were analyzed, using statistical software SPSS 16.

Of the 103 patients participating in the study, 52 patients were men and 51 were women. The mean age of participants was 9.79±70.53 years. Irrigation test diagnosed NLDO in 20 (19.4%) patients, which was significantly higher in women (P=0.013). Forty-six (4757%) patients suffered from epiphora, recorded in 12.62% (N= 13) of patients with NLDO and 34.95% (N= 36) of patients without NLDO (P= 0.068). Among patients with NLDO (N= 20), increased DDT was observed in 70% (N= 14), and among patient without NLDO (N= 83), DDT was increased in 22 patients, resulting in a sensitivity and specificity of 70% and 73.4%, respectively. There was a significant difference between patients with and without NLDO according to DDT (P=0.001).

Considering the high prevalence of NLDO, it is important to evaluate all patients undergoing cataract surgery. The easily accessible irrigation test can be used as a reliable diagnostic tool to reduce the risk of postoperative endophthalmitis.