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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Best AL, Labetoulle M, Legrand M, M'garrech M, Barreau E, Rousseau A. [Punctal and canalicular plugs: Indications, efficacy and safety (French translation of the article)]. J Fr Ophtalmol 2019; 42:404-414. [PMID: 30879835 DOI: 10.1016/j.jfo.2018.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/08/2018] [Accepted: 10/12/2018] [Indexed: 10/27/2022]
Abstract
Lacrimal occlusion with punctal or canalicular plugs have been used to treat dry eye disease for more than 40 years. Indeed, punctal plugs constitute a safe and effective tool to retain the natural tear film and prolong the effect of tear substitutes. A wide variety of plugs is available, differing in their design, location (punctal versus canalicular) and their resorbability. There indications have increasingly broadened, and they are now one of the treatment options for numerous ocular surface diseases. Current research focuses on using punctal plugs for extended delivery of drugs to the ocular surface. This review addresses physiology of lacrimal drainage, available models of punctal plugs, their indications, practical details of prescribing and placing punctal and canalicular plugs, and possible complications.
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Affiliation(s)
- A-L Best
- Service d'ophtalmologie, centre de référence maladies rares en ophtalmologie OPHTARA, hôpital Bicêtre, université Paris-Sud, DHU vision et handicap, Assistance publique-Hôpitaux de Paris, 78, rue du Général Leclerc, 94275 Le Kremlin-Bicêtre cedex, France
| | - M Labetoulle
- Service d'ophtalmologie, centre de référence maladies rares en ophtalmologie OPHTARA, hôpital Bicêtre, université Paris-Sud, DHU vision et handicap, Assistance publique-Hôpitaux de Paris, 78, rue du Général Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Immunologie des maladies virales et maladies auto-immunes (IMVA/Infrastructure IDMIT) UMR 1184, CEA, 92260 Fontenay-aux-Roses, France
| | - M Legrand
- Service d'ophtalmologie, centre de référence maladies rares en ophtalmologie OPHTARA, hôpital Bicêtre, université Paris-Sud, DHU vision et handicap, Assistance publique-Hôpitaux de Paris, 78, rue du Général Leclerc, 94275 Le Kremlin-Bicêtre cedex, France
| | - M M'garrech
- Service d'ophtalmologie, centre de référence maladies rares en ophtalmologie OPHTARA, hôpital Bicêtre, université Paris-Sud, DHU vision et handicap, Assistance publique-Hôpitaux de Paris, 78, rue du Général Leclerc, 94275 Le Kremlin-Bicêtre cedex, France
| | - E Barreau
- Service d'ophtalmologie, centre de référence maladies rares en ophtalmologie OPHTARA, hôpital Bicêtre, université Paris-Sud, DHU vision et handicap, Assistance publique-Hôpitaux de Paris, 78, rue du Général Leclerc, 94275 Le Kremlin-Bicêtre cedex, France
| | - A Rousseau
- Service d'ophtalmologie, centre de référence maladies rares en ophtalmologie OPHTARA, hôpital Bicêtre, université Paris-Sud, DHU vision et handicap, Assistance publique-Hôpitaux de Paris, 78, rue du Général Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Immunologie des maladies virales et maladies auto-immunes (IMVA/Infrastructure IDMIT) UMR 1184, CEA, 92260 Fontenay-aux-Roses, France.
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