Frequency of Nasolacrimal Duct Obstruction in Patients Undergoing Cataract Surgery,According to Irrigation Test and Dye Disappearance Test

Purpose: One of the most important risk factors for endophthalmitis after cataract surgery is the presence of nasolacrimal duct obstruction (NLDO), which can be diagnosed pre-operatively. Considering the high prevalence of cataract reported in our province, we decided to study the incidence of NLDO in a sample of patients who were candidate for cataract surgery according to irrigation and dye disappearance test (DDT). Methods: This non-randomized longitudinal descriptive study prospectively investigated all patients who underwent cataract surgery only in one service in … during 2016. All participants underwent complete eye examination, irrigation test, and DDT. Complete history was taken from all patients, particularly the history of tearing of the eyes. The main outcome measure of this study was the frequency of NLDO in a patients undergoing cataract surgery and the secondary outcome was sensitivity and specificity of DDT in a diagnosis of NLDO. Data were analyzed using statistical software SPSS Ver16.Results: Of the 103 patients participating in the study, 52 patients were men and 51 were women. The mean age of participants was 70.53±9.79 years. Irrigation test diagnosed NLDO in 20 (19.4%) patients, which significantly was higher in women (P=0.013). The forty-six (47.9%) patients complained from epiphora, recorded in 35% (N=7) of patients with NLDO and 43% (N=36) of patients without NLDO (P=0.068). Among patients with NLDO (N=20), increased DDT was observed in 70% (N=14), and among patient without NLDO (N=83), DDT was increased in 23 patients, resulting in a sensitivity and specificity of 70% and 73.4%, respectively. There is significant difference between patients with and without NLDO according to DDT (P=0.001). Conclusion: Considering the high prevalence of NLDO, it is important to evaluate all patients undergoing cataract surgery. The easily accessible irrigation test can be used as a reliable diagnostic tool to reduce the risk of postoperative endophthalmitis.