Purpose: To determine the time of normalization of conjunctival flora after successful dacryocystorhinostomy.
Methods: Forty consecutive adult patients with nasolacrimal duct obstruction and chronic dacryocystitis who had been referred for dacryocystorhinostomy were included in the study. Conjunctival cultures were obtained preoperatively from the involved and normal sides of each patient. Cultures from the lacrimal sac contents were obtained at the time of dacryocystorhinostomy. Postoperatively, conjunctival specimens were obtained from the operated side weekly until the result of the cultures was negative or the colony count was less than that of the normal side.
Results: The mean time of normalization was 4.5 weeks (range, 3-8 weeks). The time of normalization was significantly related to the type of organisms (p = 0.04) and the colony count (p < 0.001). The mean time of normalization was 3.5 weeks in patients with a colony count <10 and 4.93 weeks in patients with a colony count > or =10. The time of normalization was significantly related to the presence of a silicone tube (p < 0.0001). The mean time of normalization was 6.2 weeks and 3.9 weeks in patients with and without a silicone tube, respectively.
Conclusion: A few weeks is needed for the conjunctival flora to normalize after dacryocystorhinostomy. The time of normalization is related to the type of bacteria, colony count, and presence of silicone tube.