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Investigation of the presence of SARS-CoV-2 in the lacrimal sac and sustainability of lacrimal surgeries during the pandemic period

Objective: To investigate the reliability of dacryocystorhinostomy operations in terms of viral spread by examining the presence of severe acute respiratory syndrome (SARS) corona-virus type 2 (SARS-CoV-2) in the lacrimal sac. 
Methods: A total of 15 eyes in 14 patients of nasolacrimal duct obstruction that was scheduled for external dacryocystorhinostomy operation were prospectively included in the study. Patients who have coronavirus disease 2019 (COVID-19), had recovered from COVID-19, have a history of close contact with COVID-19 infected persons, and are with vaccination were not included in the study. A nasopharyngeal swab was taken from the surgery planned side of each patient 24 hours before their operation. All cases were real-time, reverse transcription-polymerase chain reaction (RT-PCR) negative. Lacrimal swabs were taken from the lacrimal sac during surgery in these cases. The compatibility of the RT-PCR test results from the lacrimal sac and nasopharyngeal swab was evaluated. 
Results: The mean age of the patients was 56.04 ± 14.91 years. The mean duration of nasolacrimal duct occlusion was 3.93 ± 3.40 years. RT-PCR was negative in the swabs taken from the lacrimal sac of all cases (100%). This result showed agreement with the RT-PCR test results of the nasopharyngeal swabs. 
Conclusions: Viral RNA of SARS-CoV-2 was not detected in the lacrimal sac in this study. Lacrimal sac surgeries can be performed by taking the necessary precautions.