Endoscopic dacryocystorhinostomy in warfarinized patients

Abstract 

Purpose

To report the results of endoscopic dacryocystorhinotomy (EDCR) in anticoagulated patients who did not interrupt their anticoagulant regimen for the procedure.

Materials and methods

A case note review was made of all 9 patients taking warfarin who had EDCR at Ipswich Hospital from May 1998 to October 2003. Age, gender, indications for surgery, complications, and outcome were analyzed, and the results were compared to EDCRs in nonwarfarinized patients.

Results

Of the 9 patients, 7 had complete relief of epiphora. Two patients had a persistent watering eye. One of them had blockage of upper, lower, and common canaliculi, and the other was found to have adhesions between the lateral nasal wall and middle turbinate. A total of 6 patients had no postoperative complications; 2 had minor periorbital bruising that did not delay discharge, and only 1 patient had ooze through a Kaltostat nasal pack and was kept in the hospital for 2 days. None required readmission.

Conclusions

EDCR is a safe and efficacious treatment in patients with distal nasolacrimal obstruction in anticoagulated patients and does not require stopping the warfarin perioperatively.