Dacryocystectomy: Indications and Techniques

  • Mohammad Javed Ali


Dacryocystectomy or DCT refers to a complete surgical extirpation of the lacrimal sac. It was first described by Thomas Woolhouse in 1724 and was the standard of care in its crude form, before the advent of dacryocystorhinostomy for management of dacryocystitis and lacrimal fistulae [1]. Rudolph Berlin later popularized it in the nineteenth century [1]. Dacryocystectomy in its journey since then has unfortunately seen many ups and downs and suffered major humiliation in the 1920s wherein it was described by few authors as “an act of surgical despair”; “a useless and barbaric mutilation”; and “a malpractice.” [1] We have come far from those days and DCT is now considered an important part of the lacrimal surgeon’s armamentarium. The usual approach in most of the cases is through a transcutaneous incision, except in certain exceptional circumstances where endoscopic approach may be needed [2].


Nasolacrimal Duct Orbital Cellulitis Medial Canthus Lateral Rhinotomy Cicatricial Pemphigoid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Duke-Elder S, MacFaul PA. The ocular adnexa. In: Duke-Elder S, editor. System of ophthalmology, vol 13, part II. London: Henry Kimpton; 1974. p. 715–8.Google Scholar
  2. 2.
    Shams PN, Selva D. An endoscopic endonasal approach to dacryocystectomy. Orbit. 2013;32:134–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Heindl LM, Junemann AGM, Kruse FE, Holbach LM. Tumors of the lacrimal drainage system. Orbit. 2010;29:298–306.PubMedCrossRefGoogle Scholar
  4. 4.
    Pujari A, Ali MJ, Mulay K, Naik MN, et al. The black lacrimal sac: a clinicopathological correlation of a malignant melanoma with anterior lacrimal crest infiltration. Int Ophthalmol. 2014;34:111–5.PubMedCrossRefGoogle Scholar
  5. 5.
    Low JR, Ng SB, Sundar G. Undifferentiated carcinoma of the lacrimal sac: case report and review of literature. Orbit. 2011;30:293–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Mauriello JA, Vadehra VK. Dacryocystectomy: surgical indications and results in 25 patients. Ophthal Plast Reconstr Surg. 1997;13:216–20.PubMedCrossRefGoogle Scholar
  7. 7.
    Vasilakis M, Brouzas D, Charakidas A, et al. Dacyrocystosclerotherapy. Ophthal Plast Reconstr Surg. 2001;17:111–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Baddeley PA, Lewis GD, Lane CM. A novel technique to facilitate dacryocystectomy using viscoelastic substances. Orbit. 2011;30:158–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Cook HL, Olver JM. Dacryocystectomy as a treatment of chronic dacryocystitis in a frail, elderly patient. Eye (Lond). 2004;18:334–6.CrossRefGoogle Scholar
  10. 10.
    Detorakis ET, Tsilimbaris MK. Dacryocystectomy for the treatment of nasolacrimal duct obstruction in elderly patients treated with beta-blockers. Ophthal Plast Reconstr Surg. 2009;25:417.PubMedCrossRefGoogle Scholar
  11. 11.
    Pai VH, Rao KA, Bhandary SV. Visual loss following dacryocystectomy. Ophthalmic Surg Lasers Imaging. 2006;37:494–6.PubMedGoogle Scholar
  12. 12.
    Boynton JR, Anawis MA. Role of dacryocystectomy in the management of failed dacyrocystorhinostomy associated with chronic dacryocystitis. Ophthalmic Surg Lasers. 1996;27:133–6.PubMedGoogle Scholar
  13. 13.
    Matayoshi S, Baak AV, Cozac A, et al. Dacryocystectomy: indications and results. Orbit. 2004;23:169–73.PubMedCrossRefGoogle Scholar
  14. 14.
    Ali MJ, Mulay K, Pujari A, Naik MN. Derangements of lacrimal drainage associated lymphoid tissue (LDALT) in human chronic dacryocystitis. Ocul Immunol Inflamm. 2013;21:417–23.PubMedCrossRefGoogle Scholar
  15. 15.
    Ali MJ, Honavar SG, Naik MN. Endoscopically guided minimally invasive bypass tube intubation without DCR: evaluation of drainage and objective outcomes assessment. Minim Invasive Ther Allied Technol. 2013;22:104–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Saxena RC. Anastomotic surgery after the operation of dacryocystectomy. Indian J Ophthalmol. 1975;23:16–9.PubMedGoogle Scholar

Copyright information

© Springer India 2015

Authors and Affiliations

  1. 1.Dacryology ServiceL.V. Prasad Eye InstituteBanjara Hills, HyderabadIndia

Personalised recommendations