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Pahn, Kim, and Khwarg: A Case of Acquired Dacryocystocele Treated by Lacrimal Silicone Intubation
Case Report
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(2): 333-337.

Published online: 15 February 2012

DOI: https://doi.org/10.3341/jkos.2012.53.2.333

A Case of Acquired Dacryocystocele Treated by Lacrimal Silicone Intubation

Min Seop Pahn, MD1, Mi Jeung Kim, MD2, Sang In Khwarg, MD2, 3

1Kong Eye Clinic, Seoul, Korea.

2Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.

3Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

Address reprint requests to Sang In Khwarg, MD. Department of Ophthalmology, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea. Tel: 82-2-2072-2879, Fax: 82-2-741-3187, khwarg@snu.ac.kr

Received 25 July 2011       Accepted 8 December 2011

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To report a case of an acquired dacryocystocele successfully treated with bicanalicular silicone intubation and to review relating literature.

Case summary

A 17-year-old girl visited our clinic with tearing of both eyes since birth and a mass on the right medial canthal area for 2 years. A firm, non-tender mass with a well-demarcated border was palpated in the subcutaneous level just inferior to the right medial canthal ligament. Lacrimal irrigation via the lower punctums showed reflux through the opposite punctums without nasal passage in both of her eyes. Computed tomographic scan showed a widening of the right lacrimal sac fossa and bony nasolacrimal canal and a 16 × 18 mm sized cyst-like mass in the right lacrimal sac. The patient was diagnosed with right acquired dacryocystocele associated with bilateral congenital nasolacrimal duct obstructions. After opening of the obstructed common canaliculus using a fine lacrimal probe, silicone intubation was performed. The tearing symptom improved and the mass disappeared during the subsequent follow-up period of 1 year.

Conclusions

When only accompanied by distal nasolacrimal duct obstruction, acquired dacryocystocele can be inferred to be associated with congenital nasolacrimal duct obstruction. Subsequently, bicanalicular silicone intubation can be considered as a treatment of choice.

Keywords: Congenital nasolacrimal duct obstruction, Dacryocystocele, Silicone intubation

Figures and Tables

Figure 1
Axial (A) and coronal (B) scans of the contrast-enhanced orbital CT show a 16 × 18 mm sized, well-demarcated, non enhancing, low density mass (white arrow) in the lacrimal sac area of the right eye.
jkos-53-333-g001
Figure 2
Axial (A) and coronal (B) scans show that a bony nasolacrimal canal (white arrow) is also widened.
jkos-53-333-g002

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