The Clinical Manifestations and Treatment Results of Congenital Lacrimal Fistula

ABSTRACT

PURPOSE: To evaluate the clinical manifestations and the results of treatment in congenital lacrimal fistula. METHODS: We retrospectively evaluated the symptoms, associated anomalies, and results of treatment in patients with congenital lacrimal fistula. RESULTS: The mean age of the 22 total patients was 22.5+/-24.6 years (4 months~77 years). Associated anomalies were shown in two patients - one with hearing loss and upper punctal atresia, and the other with imperforate anus and undescended testes. Symptoms were tearing in 18 eyes and subcutaneous nodule in 3 eyes. Most of the external ostium of the fistula were located at the skin inferomedial (16 eyes) or medial (5 eyes) to the medial canthus, but one case had external ostium at the medial palpebral conjunctiva. Symptom improved in all patients after fistulectomy with bicanalicular intubation in 12 eyes, fistulectomy in 1 eye, bicanalicular intubation in 1 eye, and dacryocystorhinostomy combined fistulectomy with bicanalicular intubation in 2 eyes. However, the fistula recurred in 3 cases (19%). CONCLUSIONS: Lacrimal fistula is a congenital anomaly which can cause tearing or subcutaneous nodule. Treatment appropriate to the patient is required to get favorable result.