Surgical management of traumatic nasolacrimal duct obstruction.

PURPOSE: To evaluate etiologies, demographics, and surgical outcomes in cases of traumatic nasolacrimal duct obstruction (NLDO).

METHODS: Charts of 35 patients with the diagnosis of traumatic NLDO were reviewed retrospectively. Patient demographics, type of trauma, previous lacrimal surgery history, surgical treatment, follow-up time, and anatomical and functional outcomes were evaluated.

RESULTS: Forty eyes of 35 patients were included in this study over 12 years. Twenty-four patients were male (68.5%) and the mean age of the patients was 31.52 ± 14.58 years (range 9-68). The most common etiology was motor vehicle accidents (52.5%), followed by high velocity blunt injury (27.5%), accidental fall (7.5%), occupational trauma (5%), iatrogenic surgical trauma (5%), and animal bite (2.5%). A total of 21 eyes (52.5%) were treated with external dacryocystorhinostomy (DCR), 30% with conjunctival DCR, 15% with endoscopic DCR, and 2.5% with diode laser-assisted DCR. Mean follow-up time was 23.02 ± 13.53 months. Functional and anatomical success was recorded in 37 out of 40 eyes (92.5%).

CONCLUSIONS: Naso-orbitoethmoidal fracture is the main etiology of traumatic NLDO. The majority of the injuries occurred in male participants from motor vehicle accidents and high-velocity blunt injury. Dacryocystorhinostomy provides anatomical and functional success in 92.5% of cases of traumatic NLDO.