Orbital Cellulitis Secondary to Dacryocystitis: A Case Series and Literature Review.

Autor:	O'Rourke M; Department of Ophthalmology, Mater Misericordiae University Hospital, University College Dublin, Dublin, Ireland., Tang YF; Orbital, Plastics and Lacrimal Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia., Pick Z; Orbital, Plastics and Lacrimal Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia., Tan JS; Orbital, Plastics and Lacrimal Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia., Tan PEZ; Department of Ophthalmology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia., Athavale DD; Department of Ophthalmology, Royal North Shore Hospital, Sydney, New South Wales, Australia., O'Donnell B; Department of Ophthalmology, Royal North Shore Hospital, Sydney, New South Wales, Australia., Selva D; Discipline of Ophthalmology and Visual Science, University of Adelaide, Adelaide, South Australia, Australia., Gajdatsy A; Department of Ophthalmology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia., Hardy TG; Orbital, Plastics and Lacrimal Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.; Department of Ophthalmology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.; Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.; Centre for Eye Research Australia, Departments of Ophthalmology and Surgery, University of Melbourne, East Melbourne, Victoria, Australia., McNab A; Orbital, Plastics and Lacrimal Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.; Centre for Eye Research Australia, Departments of Ophthalmology and Surgery, University of Melbourne, East Melbourne, Victoria, Australia., Khong JJ; Orbital, Plastics and Lacrimal Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.; Department of Ophthalmology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.; Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.; Centre for Eye Research Australia, Departments of Ophthalmology and Surgery, University of Melbourne, East Melbourne, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	Ophthalmic plastic and reconstructive surgery [Ophthalmic Plast Reconstr Surg] 2024 Dec 09. Date of Electronic Publication: 2024 Dec 09.
DOI:	10.1097/IOP.0000000000002834
Abstrakt:	Purpose: This study aimed to determine risk factors, and describe management and outcomes in patients who developed orbital cellulitis secondary to dacryocystitis. Methods: Multicenter retrospective case series with 18 patients and review of published cases. Results: The mean age was 62 years, 56% were female and 50% had recurrent dacryocystitis. Visual acuity was reduced in the affected eye with a mean of 0.27 logMAR (Snellen 20/40) which improved to 0.15 logMAR (Snellen 20/30) at final follow up. Two cases (12%) had dacryoliths and 1 patient had sarcoidosis within the lacrimal sac. Gram-positive bacteria were identified in 73% (11/15), gram-negative bacteria in 13% (2/15), and mixed infection in 13% (2/15), respectively. Cases who had dacryocystorhinostomy as definitive treatment, either acutely (n = 3) or electively (n = 10) had full resolution. Transcutaneous drainage of the medial wall abscess in 10 patients helped resolve acute cellulitis. Four patients declined dacryocystorhinostomy after transcutaneous drainage; 2 had repeated dacryocystitis and orbital cellulitis, while 2 had no further infective episodes. One immunosuppressed patient had rapid progression to non-perception-of-light vision due to fungal invasion. Forty-six published cases reported up to 28% permanent loss of vision (perception-of-light and non-perception-of-light). Dacryoliths were discovered in 17% of published cases. Conclusions: Orbital cellulitis complicating dacryocystitis appears to be related to recurrent dacryocystitis and possibly the presence of dacryoliths. Immunosuppression is identified as a poor prognostic factor in this series. While transcutaneous drainage works well as a temporizing measure, dacryocystorhinostomy either done acutely or deferred until resolution of orbital cellulitis is required for definitive cure. Competing Interests: The authors have no financial or conflicts of interest to disclose. (Copyright © 2024 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.)
Databáze:	MEDLINE
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