Obstructive lacrimal disease in the Palestinian community of the west bank and Gaza strip

ABSTRACT

Purpose To delineate the disease associations of obstructive lacrimal disease in the Palestinian community of the West Bank and Gaza Strip and to evaluate the outcome of lacrimal surgery. Methods A prospective study of the causes of obstructive lacrimal disease in 68 patients was carried out. The causes and outcome of a series of 30 dacryocystorhinostomies [DCR] is reported. Thirty intraoperative lacrimal dissections were performed in order to correlate operative pathology with the associated disease. Results Diseases commonly associated with obstructive lacrimal disease were found to be vernal, nasal and paranasal sinus disease 51.4%, inactive trachoma 30.8%, congenital obstruction 14.7%, and idiopathic 2.9%. Canalicular obstruction was commonly associated with inactive trachoma. Lacrimal sac disease, in particular mucocele, was associated with obstruction due to vernal disease. Follow up of lacrimal surgery was obtained for two thirds of operated patients only. The operation performed for patients with longstanding pathology affecting both lacrimal sac and canaliculi was DCR with routine positioning of O'Donahue tubes. Eighty% of operated patients obtained relief of or had obstructive symptoms improved. Patients also noted cosmetic improvement. Conclusions The DCR with intubation provides a safe, reliable surgical option with reasonable results in the relief of obstructive lacrimal disease in an economically deprived, developing community with a high incidence of lacrimal disease. With the decline of endemic [active] trachoma, vernal disease of the external eye and paranasal sinus is now the most common pathology associated with obstructive lacrimal disease in this region