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Pal SS, Alam MS. Lacrimal Canaliculitis: A Major Review. Semin Ophthalmol 2024:1-9. [PMID: 38762795 DOI: 10.1080/08820538.2024.2354689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
Lacrimal canaliculitis is an inflammation of the proximal lacrimal drainage system. It classically presents with symptoms of redness, mucopurulent discharge, medial canthal swelling, epiphora, and pouting punctum. Despite having classical clinical characteristics it is frequently misdiagnosed. The cause can be primarily due to various infectious agents or secondary mostly due to the use of punctal plugs. There are no universally accepted guidelines for the management of canaliculitis but different medical and surgical options have been employed with varying success rates and it is notorious for recurrences and failure to therapy. The present review summarizes the existing literature on lacrimal canaliculitis published over the past 15 years to provide an overview of this uncommon condition. A total of 100 articles published in the literature were anlaysed during this period. The mean age at diagnosis was 57.09 ± 16.91 years with a female preponderance. Misdiagnosis was common with many patients misdiagnosed as conjunctivitis and dacryocystitis. Primary canaliculitis was found to be more frequent than secondary with inferior canaliculus involved more commonly than the superior. Staphylococcus, Streptococcus, and Actinomyces were the most common microbes isolated. Surgical management was employed in 74.25% of cases while medical management was done in 20.82% of cases. The review presents an insight into the complexities of canaliculitis, its diagnosis, and management which will further help to improve the understanding of this uncommon infection of the lacrimal system.
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Affiliation(s)
- Soham S Pal
- Department of Ophthalmology, Dr. Vaishampayan Memorial Government, Medical College, Solapur, Maharashtra, India
| | - Md Shahid Alam
- Orbit, Oculoplasty, Reconstructive & Aesthetic Services, Aditya Birla Sankara Nethralaya, Kolkata, India
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Ding J, Zhang Y, Feng H, Sun H. Actinomycotic primary canaliculitis: Predisposing factors, clinical characteristics, and treatment outcomes. Eur J Ophthalmol 2023; 33:2194-2200. [PMID: 36927124 DOI: 10.1177/11206721231163612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Ocular actinomycosis is an uncommon progressive infection. The study aims to investigate the predisposing factors, clinical characteristics and treatment outcomes of culture-proven cases of Actinomycotic primary canaliculitis. METHODS Single-center, retrospective, interventional case series. Culture-proven cases of Actinomyces-associated primary canaliculitis diagnosed and treated between January 2017 and December 2021 at the Beijing Tongren Eye Center, Capital Medical University were identified and reviewed for ocular and systemic risk factors, clinical presentations, microbiological profile, treatment modalities and outcomes. RESULTS Of the 201 patients diagnosed with primary canaliculitis, 22 (10.9%) were caused by Actinomyces. The mean age at onset of 22 patients (21 women and one men) was 54 years. The lower canaliculus was most commonly involved (54.6%). The most frequent symptom was mattering without epiphora (77.3%) and clinical signs were punctal regurgitation of purulent discharge (100%) and expressible concretions (95.5%). Dry eye co-existed in 77.3% of patients, whereas no obvious systemic factors were found. Among 19 cases (86.0%) of identified Actinomyces species, A. odontolyticus (43.5%) was the predominant causative microorganism. There were 50% of patients with polymicrobial infection and the most common additional bacteria isolated were Streptococcus species. Conservative therapy combining repeated canalicular expression and irrigation with susceptible topical antibiotics achieved complete resolution in 86.4% of patients. CONCLUSIONS Dry eye was identified in the vast majority of patients with Actinomycotic canaliculitis. Most cases are odontogenic in origin and the infection occurs in immunocompetent individuals. The conservative method combining canalicular expression and irrigation with topical susceptible antibiotics is recommendable as initial therapy.
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Affiliation(s)
- Jingwen Ding
- Department of Oculoplastic Surgery, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Yang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Hui Feng
- Department of Oculoplastic Surgery, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Hua Sun
- Department of Oculoplastic Surgery, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
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Wang M, Ma Y, Tu Y, Wu W, Yu B. A prospective study comparing mini-invasive and conventional canaliculotomy of punctum-sparing canaliculotomy for primary canaliculitis treatment. Eye (Lond) 2023; 37:2289-2293. [PMID: 36473974 PMCID: PMC10366210 DOI: 10.1038/s41433-022-02333-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 10/17/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To compare outcomes of mini-invasive canaliculotomy with those of conventional canaliculotomy conducted using the punctum-sparing approach for the treatment of primary canaliculitis. METHODS A prospective, comparative, and interventional case series study was conducted on 118 individuals with unilateral inferior primary canaliculitis. These patients were randomly divided into two groups, each with 59 cases. Group A underwent mini-invasive canaliculotomy (minor incision ~3 mm), whereas group B received conventional canaliculotomy (long incision ~6-8 mm). Punctum-sparing and canaliculus-reconstructing procedure was used to treat all patients. Both groups had silicone tube intubations and were retained in the lacrimal passages for one month. Both groups' surgical success rates and postoperative complications were measured at the last follow-up of 12 months after surgery. RESULTS A total of 108 patients were finally included in the study, 53 in group A and 55 in group B. There were 79 females and 29 males with a median age of 57 ± 13.4 years. The anatomical success rates for groups A and B were 96.2% and 92.7% (P = 0.679), respectively. Functional success rate was accomplished by considerably more patients in group A (50/53, 94.3%) compared to group B (45/55, 81.8%) (P = 0.046). No recurrences were seen during follow-up visits in any of the participants. CONCLUSIONS The two procedures employed in this study to treat primary canaliculitis achieves excellent clinical effects with no incidence of recurrence. The mini-invasive canaliculotomy is worthy to be recommended for its higher functional success rate with mini-invasion of canaliculus and intact lacrimal punctum.
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Affiliation(s)
- Mingling Wang
- Department of Ophthalmology, Baoan Central Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Yingjie Ma
- Department of Orbital and Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yunhai Tu
- Department of Orbital and Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wencan Wu
- Department of Orbital and Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Bo Yu
- Department of Orbital and Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Huang W, Cao S, Xie L, Li X, Meng Z, Yu X, Huang D, Chen R, Liang X. Efficacy and safety of super pulse CO2 laser-assisted punctoplasty with canalicular curettage in primary canaliculitis. Lasers Med Sci 2023; 38:75. [PMID: 36807698 PMCID: PMC9938812 DOI: 10.1007/s10103-023-03735-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/05/2023] [Indexed: 02/21/2023]
Abstract
The objective of this study was to evaluate the efficacy and safety of super pulse CO2 laser-assisted punctoplasty with canalicular curettage in primary canaliculitis. In this retrospective serial case study, the clinical data of 26 patients who underwent super pulse CO2 laser-assisted punctoplasty for the treatment of canaliculitis were collected from January 2020 to May 2022. The clinical presentation, intraoperative and microbiologic findings, surgical pain severity, postoperative outcome, and complications were studied. Of the 26 patients, most were females (female:male 20:6), with a mean age of 60.1 ± 16.1 years (range, 19-93). Mucopurulent discharge (96.2%), eyelid redness and swelling (53.8%), and epiphora (38.5%) were the most common presentations. During the surgery, concretions were present in 73.1% (19/26) of the patients. The surgical pain severity scores ranged from 1 to 5, according to the visual analog scale, with a mean score of 3.2 ± 0.8. This procedure resulted in complete resolution in 22 (84.6%) patients and significant improvement in 2 (7.7%) patients, and 2 (7.7%) patients required additional lacrimal surgery with a mean follow-up time of 10.9 ± 3.7 months. The surgical procedure of super pulse CO2 laser-assisted punctoplasty followed by curettage appears to be a safe, effective, minimally invasive, and well-tolerated treatment for primary canaliculitis.
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Affiliation(s)
- Weifeng Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Shujuan Cao
- Ophthalmologic Center, Affiliated Kashi Hospital of Sun Yat-sen University, First People's Hospital of Kashi Prefecture, Kashi, 844000, China
| | - Lingling Xie
- Ophthalmologic Center, Affiliated Kashi Hospital of Sun Yat-sen University, First People's Hospital of Kashi Prefecture, Kashi, 844000, China
| | - Xingyi Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Ziwei Meng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Xinyue Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Danping Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Rongxin Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Xuanwei Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
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Long-Term Outcomes of Canaliculotomy with Silicone Tube Intubation in the Management of Canaliculitis. J Clin Med 2022; 11:jcm11226830. [PMID: 36431305 PMCID: PMC9698917 DOI: 10.3390/jcm11226830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/31/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
As a rare and often misdiagnosed disease of the lacrimal apparatus, only limited data exist on long-term outcomes of surgical methods for the treatment of primary canaliculitis. The aim of this study was to evaluate canaliculotomy with silicone tube intubation (STI) as a surgical procedure for canaliculitis in a long-term follow-up setting. A total of 25 eyes of 25 patients with canaliculitis treated with canaliculotomy and STI at the University of Muenster Medical Center, Germany, from 2015 to 2021 were included in this study. Data analysis involved clinical symptoms, complications, duration of STI and rate of recurrence. Mean patient age was 63.7 ± 17.2 years. After a follow-up time of 3.7 ± 1.5 years, 88% of cases showed no recurrence of inflammation. The mean duration of STI was 5.8 ± 3.4 months. Complications such as post-operative hemorrhage, spread of infection, obstruction of the canaliculus or migration of the STI were not observed in any of the patients. However, tube dislocation occurred in four cases, a pyogenic granuloma in two cases and a fistula formation in one case. The management of canaliculitis by canaliculotomy with STI showed very good postoperative outcomes and low complication rates in the long-term and can therefore be considered a safe and successful surgical approach.
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Ali MJ, Malhotra R, Rose GE, Patel BCK. Holding back the tears: does marsupialisation of a remnant canaliculus after tumour resection help eliminate epiphora? BMJ Open Ophthalmol 2022; 7:e001090. [PMID: 36161835 PMCID: PMC9389097 DOI: 10.1136/bmjophth-2022-001090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mohammad Javed Ali
- Govindram Seksaria Institute of Dacryology, LV Prasad Eye Institute, Hyderabad, India
| | - Raman Malhotra
- Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
| | - Geoffrey E Rose
- Adnexal Unit, Moorfields Eye Hospital City Road Campus, London, UK
| | - Bhupendra C K Patel
- Departments of Plastic Surgery and Ophthalmology and Visual Sciences, University of Utah Health, Salt Lake City, Utah, USA
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Ali MJ, Malhotra R, Patel BC. Routine punctoplasty: isn't it time we preserved the integrity of the punctum? Orbit 2022; 41:407-412. [PMID: 35502152 DOI: 10.1080/01676830.2022.2055087] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Punctoplasty is a common procedure in the management of punctal stenosis and was first described by Sir William Bowman in 1853. Several types of punctoplasty are described, and include 1-snip, 2-snip, triangular 3-snip, rectangular 3-snip and 4-snip procedures. The understanding of the anatomy and physiology of the punctum has greatly improved in the last decade aided by electron microscopic and molecular techniques. The use of minimally invasive modalities for primary cases is on the rise with successful preservation of the physiological functions of the punctum and canaliculus. The paper reviews the current anatomical and physiological evidence to present an alternative perspective. Given our evolving understanding, it may be time to debate the practice of performing routine punctoplasty.
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Affiliation(s)
- Mohammad Javed Ali
- Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India
| | - Raman Malhotra
- Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, UK
| | - Bhupendra C Patel
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
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Wang M, Cong R, Yu B. Outcomes of Canaliculotomy with and without Silicone Tube Intubation in Management of Primary Canaliculitis. Curr Eye Res 2021; 46:1812-1815. [PMID: 34275398 DOI: 10.1080/02713683.2021.1942074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To compare the outcomes of canaliculotomy and curettage with and without silicone tube intubation in the treatment of primary canaliculitis. METHODS A prospective, randomized, interventional case series was performed. Fifty patients diagnosed with unilateral inferior primary canaliculitis underwent canaliculotomy with curettage and were randomly divided into two groups depending on silicone tube intubation. Twenty-five patients were recruited in group A (without intubation) and 25 patients were recruited in group B (with intubation). The resolution of infection, the success rate and postoperative complications observed in both groups were analyzed with a minimum follow-up of 1 year. RESULTS Forty-seven patients were finally included in the study consisting of 23 patients in group A and 24 patients in group B. There were 33 females and 14 males with a median age of 57 ± 13.9 years (range 29-89 years). All patients recorded complete resolution of canaliculitis and no recurrent infections were observed in the 2 groups during follow-up. A significantly higher number of anatomical and functional successes were achieved in patients in group B (100%, 87.5%) than in group A (78.3%, 60.9%) (P < .05,). The surgical complication of canalicular obstruction was significantly higher in patients in group A (21.7%, 5/23) compared to group B (0/24)(P < .05). CONCLUSION Canaliculotomy with curettage gives excellent clinical outcomes in the treatment of patients with primary canaliculitis and a higher success rate can be achieved when silicone tube intubation is performed during the procedure. The use of silicone tube intubation may be a necessary choice in canaliculotomy to avoid post-operative canalicular obstruction.
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Affiliation(s)
- Mingling Wang
- Department of Ophthalmology, Baoan Central Hospital of Shenzhen (The Fifth Affiliated Hospital of Shenzhen University), Shenzhen, China
| | - Richang Cong
- Department of Ophthalmology, Baoan Central Hospital of Shenzhen (The Fifth Affiliated Hospital of Shenzhen University), Shenzhen, China
| | - Bo Yu
- Department of Orbital and Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, Wenzhou, China
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Landman-Vu J, Fayet B, Racy E, Hanna NG, Merle H. Primary Lacrimal Canaliculitis with clinically detected concretions: One-snip punctoplasty with lateral canaliculotomy vs. punctum sparing canalicular curettage. J Fr Ophtalmol 2021; 44:855-862. [PMID: 34020811 DOI: 10.1016/j.jfo.2020.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 08/10/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE To compare two distinct surgical techniques in the management of chronic Primary Lacrimal Canaliculitis (PLC) with clinically detectable concretions. MATERIALS AND METHODS Inclusion criteria: Patients presenting with symptoms consistent with the diagnosis of primary lacrimal canaliculitis (PLC) with ocular involvement were gathered. Gomori-Grocott Methenamine Silver test was used for concretion staining. Two groups were identified based on the surgical technique. Group A consisted of patients who underwent a punctum sparing canalicular curettage using a chalazion curette, while the patients in Group B underwent one-snip punctoplasty with lateral canaliculotomy. Failure was defined as recurrence of the initial symptoms at any time (ocular and canalicular inflammation with purulent discharge and pouting punctum). The results were analyzed by comparisons using a Fisher's exact test. RESULTS Ninety-six consecutive patients (96) with a confirmed diagnosis of PLC underwent surgical treatment between 1987 and 2017. Data were collected and divided based on the surgical technique discussed above (Group A and B). Group A: 51 cases with a mean follow-up time of 22 months [1-224] presented with a mean age of 51.5 [25-83] and a surgical failure rate of 19.6%. Group B: 45 patients with a mean follow-up time of 27 months [1-176], a mean age of 68 [17-87] years and a surgical failure rate of 4.4%. Statistical significance was demonstrated, with a p-value of 0.033, odds ratio (OR) of 0.1936 and Standard Deviation (SD) at a 95% confidence interval of [0.0195-0.9885]. CONCLUSIONS One-snip punctoplasty with lateral canaliculotomy is a simple, fast and effective procedure that allows better anatomical visualization intraoperatively and is thus shown to be statistically superior to punctum sparing canalicular curettage using a chalazion curette.
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Affiliation(s)
- J Landman-Vu
- OphtalmoPôle, Hôpital Cochin, 27, rue du Faubourg Saint Jacques, 75014 Paris, France.
| | - B Fayet
- OphtalmoPôle, Hôpital Cochin, 27, rue du Faubourg Saint Jacques, 75014 Paris, France
| | - E Racy
- ENT, Fondation Saint Jean de Dieu, 2, rue Rousselet, 75007 Paris, France
| | - N-G Hanna
- OphtalmoPôle, Hôpital Cochin, 27, rue du Faubourg Saint Jacques, 75014 Paris, France
| | - H Merle
- CHU Pierre Zobda Quitman, CS 90632, Fort de France Cedex, France
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Su Y, Zhang L, Li L, Fan X, Xiao C. Surgical procedure of canaliculoplasty in the treatment of primary canaliculitis associated with canalicular dilatation. BMC Ophthalmol 2020; 20:245. [PMID: 32563241 PMCID: PMC7305593 DOI: 10.1186/s12886-020-01503-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/02/2020] [Indexed: 11/10/2022] Open
Abstract
Background Primary canaliculitis is a chronic infection of the proximal lacrimal pathway. We aimed to evaluate surgical outcomes of a canaliculoplasty procedure for primary canaliculitis associated with canalicular dilatation. Methods This study enrolled 42 primary canaliculitis patients with canalicular dilatation who underwent canaliculoplasty. All patients were treated with canaliculotomy, curettage of canalicular contents and canaliculoplasty with stent placement. Patients’ demographics, clinical features, and follow-up outcomes were evaluated. Results There were 12 males and 30 females with a mean age of 66.1 ± 13.9 years. The mean duration time from the first onset of signs/symptoms to diagnosis was 30.6 ± 39.5 months. Epiphora (90.5%) and mucopurulent discharge from punctum (85.7%) were the most common signs. Thirty-three out of 42 patients (78.6%) achieved complete remission with a mean follow-up time of 25.3 ± 12.9 months. There were 3 patients found to have canalicular stenosis due to obstruction after surgery. Conclusion Canalicular dilatation is a severe condition of primary canaliculitis, probably due to a combined result of long standing disease and the presence of concretions. The surgical procedure of canaliculoplasty can be a highly effective treatment for primary canaliculitis associated with canalicular dilatation.
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Affiliation(s)
- Yun Su
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Leilei Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Lunhao Li
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Xianqun Fan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China. .,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
| | - Caiwen Xiao
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China. .,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
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Eraslan Yusufoğlu E, Güngör Kobat S. Pediatric Canaliculitis: A Case Report. Turk J Ophthalmol 2019; 49:102-105. [PMID: 31055896 PMCID: PMC6517850 DOI: 10.4274/tjo.galenos.2018.04453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Canaliculitis is a rare disease that relapses when not properly diagnosed and treated. It usually occurs in middle-age and advanced age. It is extremely rare in children and infants. A healthy 12-year-old girl presented with lower eyelid swelling and watery discharge in her right eye. During the last 2 years, the patient had been examined several times for the same complaints but there was no improvement despite treatment. Examination showed that the lower punctum had a pouting punctum appearance, and applying pressure to the lacrimal sac area resulted in purulent discharge. Lavage showed that the lacrimal passage was patent. In light of these clinical findings, the patient was diagnosed with canaliculitis. Punctoplasty with surgical curettage of the dacryoliths were performed. After the surgical procedure, a topical antibiotic was prescribed. Histopathological examination of the dacryoliths revealed that the infective cause was Actinomyces. No recurrence or complications were observed during 12 months follow-up.
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Ding J, Sun H, Li D. Persistent pediatric primary canaliculitis associated with congenital lacrimal fistula. Can J Ophthalmol 2017; 52:e161-e163. [PMID: 28985821 DOI: 10.1016/j.jcjo.2017.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/28/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Jingwen Ding
- Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hua Sun
- Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Dongmei Li
- Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
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13
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Incision-sparing management of canaliculitis: an efficacious alternative to surgical management. Can J Ophthalmol 2017; 52:258-263. [DOI: 10.1016/j.jcjo.2016.10.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 09/26/2016] [Accepted: 10/05/2016] [Indexed: 11/24/2022]
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Lee HK, Park JH, Lee JS, Lee H, Baek SH. Therapeutic Effect of Squeezing the Punctum and Lacrimal Canaliculus in Canaliculitis Patients. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.5.700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Hyun Kyu Lee
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Jin Hwan Park
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Joon Sik Lee
- Department of Ophthalmology, Cheonan Chungmu Hospital, Cheonan, Korea
| | - Hwa Lee
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Se Hyun Baek
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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Vertical Canaliculotomy With Retrograde Expression of Concretions for the Treatment of Canaliculitis. Ophthalmic Plast Reconstr Surg 2015; 31:119-21. [DOI: 10.1097/iop.0000000000000213] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
PURPOSE To report our results of canaliculitis treatment with our incision-sparing technique which includes dilation of the punctum and compression of the canaliculus to express the sulphur granules, curettage and irrigation of the canaliculus with antibiotic solutions, and topical antibiotic use. METHODS The medical records of all patients treated for canaliculitis between October 2009 and March 2013 were rewiewed. The punctum of affected canaliculus was dilated under local anesthesia. Then, starting just distal to common canaliculus, the horizontal canaliculus was compressed along its entire length using either a forceps or a cotton tip applicator on the conjunctival surface and a curette on the skin. Compression was repeated until no more sulphur granules appeared and the swelling of the canaliculus disappeared. A chalazion curette was inserted into canaliculus to evacuate any residual concretions. The canaliculus were irrigated with antibiotic solutions and the patients were prescribed topical antibiotic solutions for one month Patients with follow-up less than 3 months after the intervention were excluded from the study. RESULTS Nine patients met criteria for canaliculitis. There were 1 male and 8 female patients. Median age of the patients was 53 years (range 36-72 years). All patients had unilateral lower canaliculitis. Mean duration of the symptoms was 13.4 months (range 4-36 months). We followed up all patients for at least 3 months after the intervention. The signs and symptoms resolved completely in all patients within 1 month and recurrence was not observed in any patient. No patients reported epiphora after the procedure. CONCLUSION Our incision-sparing technique is effective in the treatment of canaliculitis. We suggest that minimally invasive or incision-sparing techniques be attempted before canaliculotomy to decrease postoperative complications rates.
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Abstract
Canaliculitis is an uncommon, often misdiagnosed diagnosis because canaliculitis can mimic many other common ocular conditions. Canaliculitis should be appropriately diagnosed and treated to avoid recurrent inflammation and possible obstruction of the upper portion of the lacrimal system. This review will serve as a concise resource to aid in diagnosis and provide updated management options.
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