97th DOG Annual Meeting 1999

P651

COMPLICATION DURING DACRYOCYSTOGRAPHY

M. L├╝chtenberg, K.-H. Emmerich


Case report: A 50-year-old female patient was referred to our clinics with a stenosis of the right lacrimal duct. One year history of epiphora of the right eye. The flushing of the lower lacrimal point showed a contralateral watery reflux. During the routine dacryocystography a perforation of the lacrimal duct system occured with evacuation of contrast medium Lipiodol® (fatty acids ethyl ester of iodinate oil papaverine) into the extravasal cavity. The dacryocystography as well as the nuclear magnetic resonance tomography showed a perforation with unstructured spreading of contrast medium in the surrounding tissue. After a few days a phlegmonia of the lid developped; following application of local and systemical antibiotics calmed the inflammatory situation down. During a period without inflammation, after six weeks, a dacryocystorhinostomia externa was carried out; the dacryoendoscopy showed chronical inflammatory signs of the mucous membrane and an exploratory excision showed histologically a foreign body reaction in the extravasal tissue.

Conclusion: During the routine dacryocystography a perforation of the lacrimal duct system can happen with evacuation of contrast medium Lipiodol® into the extravasal cavity. Nevertheless this procedure should remain as an important diagnostic und minimal invasive instrument. In this way the dacryoendoscopy of the lacrimal system wins more and more importance to check the operation-indication, because it allows direct assessment of the mucosa conditions.

Eye clinic, Klinikum Darmstadt, Heidelberger Landstr. 379, D-64297 Darmstadt


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