The incidence of symptomatic acquired lacrimal outflow obstruction among residents of Olmsted County, Minnesota, 1976-2000 (an American Ophthalmological Society thesis)

John J Woog, John J Woog

Abstract

Purpose: To define the incidence, clinical characteristics, and outcomes following treatment of symptomatic acquired lacrimal outflow obstruction (SALOO) in Olmsted County, Minnesota, from 1976 to 2000, and to test the hypothesis that the incidence of this disorder increased over this interval.

Methods: In this retrospective, population-based study, the Rochester Epidemiology Project was used to identify patients above the age of 5 years with SALOO. Patient medical records were reviewed, and the incidence and localization of lacrimal obstruction were determined.

Results: Five-hundred eighty-seven patients with SALOO were identified, with an average annual incidence rate of 30.47 per 100,000. Nasolacrimal duct obstruction was most common, with an incidence of 20.24 per 100,000. The increase in incidence from 1976-1979 to 1996-2000 was statistically significant (P=.01). Among 397 patients with nasolacrimal duct obstruction, 107 (27%) were male and 290 (73%) female, with a mean age of 59.5 +/- 22 years. SALOO and nasolacrimal duct obstruction incidence increased with age. Glaucoma, dry eye, cataract, diabetes mellitus, systemic malignancy, cigarette smoking, and hypertension were noted in 5.5%, 8.7%, 37.5%, 10.9%, 18.5%, 26.4%, and 41.1% of patients, respectively. One hundred eleven patients underwent dacryocystorhinostomy, with a success rate of 94.1%.

Conclusions: SALOO incidence increased during the study interval, although a possible plateau effect was noted during the last 5 years of the study period. The majority of patients were female above the age of 66 years. The latter finding, in conjunction with US demographic trends, suggests that the frequency of SALOO may continue to increase in the future. External dacryocystorhinostomy appeared to be effective in the management of nasolacrimal duct obstruction.

Figures

FIGURE 1
FIGURE 1
Adjusted annual incidence rates of all forms of dacryostenosis for 5-year intervals from 1976 through 2000.
FIGURE 2
FIGURE 2
Adjusted annual incidence rates of nasolacrimal duct obstruction for 5-year intervals from 1976 through 2000.
FIGURE 3
FIGURE 3
Annual incidence rates of all forms of dacryostenosis for the period 1976–2000 by age.
FIGURE 4
FIGURE 4
Annual incidence rates of nasolacrimal duct obstruction for the period of 1976–2000 by age.
FIGURE 5
FIGURE 5
Kaplan-Meier survival curve analysis for punctoplasty success.
FIGURE 6
FIGURE 6
Kaplan-Meier survival curve analysis for dacryocystorhinostomy (DCR) success.
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https://www.ncbi.nlm.nih.gov/pmc/articles/instance/2258133/bin/1545-6110_v105_p649-s007c.jpg

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