To Investigate efficacy and safety of early endonasal endoscopic dacrocystorhinostomy (En-DCR) in acute suppurative dacryocystitis (ASD).

Consecutive patients referred with ASD and lacrimal abscess underwent cold steel En-DCR within five days after starting systemic antibiotic, from June 2013 to September 2014. All patients received systemic antibiotic at least one day before and continued after operation for a minimus of 4 days. Resolution of clinical findings of cellulitis, resolution of epiphora and discharge, patency of lacrimal drainage assessed by irrigation test.

Twenty-two patients with ASD that underwent En-DCR were included. Mean age of patients was 36.5 (SD= ± 17.8, range=14-74). Fourteen (63.6%) were female. Mean time of resolution of cellulitis was 6.7 (SD=±4.06, range= 1-14) days. Mean follow-up time was 6.1 (SD=±3.36) months. Two patients (9.1%) showed recurrence of discharge. Two cases had return of fluid on irrigation test. Overall short term success rate was 90.9%. No major complication was found.

Early En-DCR in acute suppurative dacryocystitis could both hasten resolution of abscess and cellulitis and nasolacrimal duct obstruction with a low morbidity. Early En-DCR could be regarded as an alternative management option in patients with ASD.