Frequency Of Lacrimal Duct Obstruction In Patients Who Underwent Cataract Surgery.

Nasolacrimal duct obstruction is popular disease that may cause postoperative intraocular infection in patients who receive cataract surgery. However, it is still unclear how many patients have such ocular condition. We investigated the frequency of nasolacrimal duct obstruction in patients who underwent cataract surgery based on lacrimal irrigation test. 

This is prospective analysis of consecutive patients with cataract.

We analyzed consecutive patients who visited Japanese Red Cross Society Osaka Hospital from February 7th to March 8th. Lacrimal irrigation test was routinely performed, and nasolacrimal duct obstraction was defined. Tear meniscus height was also measured quantitatively using AS-OCT(CASIA2;Tomey). The presence of chalasis was defined using AS-OCT. The use of dry eye drops and glaucoma eye drops were determined through medical interviews.

Finally, 136 eyes from 68 consecutive patients were enrolled this study. Of 136 eyes, 14 eyes (10.3 %) showed nasolacrimal duct obstruction based on lacrimal irrigation test. We also analyzed tear meniscus height using AS-OCT, and found that 13 patients showed chalasis. After excluding eyes with chalasis, multiple regression analysis revealed that TMH was higher in patients with nasolacrimal duct obstruction  than that in patients without nasolacrimal duct obstruction (P = 0.0191). We also revealed that TMH was higher in male (P = 0.0345). Age showed mild association with TMH (P = 0.0689).

The frequency of nasolacrimal duct obstruction is higher than we expected. It has been reported that  lacrimal duct obstruction  increases the risk of postoperative endophthalmitis. We speculate that routine lacrimal irrigation test before intraocular surgery may be recommended. AS-OCT can help to suspect the presence of nasolacrimal duct obstruction during pre-cataract surgery.