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2015 ; 94
(39
): e1611
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Novel Therapy for Primary Canaliculitis: A Pilot Study of Intracanalicular
Ophthalmic Corticosteroid/Antibiotic Combination Ointment Infiltration
#MMPMID26426646
Xu J
; Liu Z
; Mashaghi A
; Sun X
; Lu Y
; Li Y
; Wu D
; Yang Y
; Wei A
; Zhao Y
; Lu C
; Hong J
Medicine (Baltimore)
2015[Sep]; 94
(39
): e1611
PMID26426646
show ga
In patients with primary canaliculitis, conservative medical therapy is
associated with a high recurrence rate. Surgical treatments carry a great
resolution rate but sometimes can result in the lacrimal pump dysfunction and
canalicular scarring. The aim of this study is to introduce a minimally invasive
approach, intracanalicular ophthalmic corticosteroid/antibiotic combination
ointment infiltration (IOI, intracanalicular ointment infiltration), and to
report our preliminary results for treating primary canaliculitis. In this
retrospective, interventional case series, 68 consecutive patients with newly
developed primary canaliculitis at a major tertiary eye center between January
2012 and January 2015. Thirty-six patients received conservative medical
treatment alone (group 1; 36 eyes). Twenty-two patients and 10 medically
uncontrolled patients from group 1 underwent IOI therapy (group 2; 32 eyes). Ten
patients and 26 recurrent patients from group 1 and group 2 underwent surgery
(group 3; 36 eyes). Patients were followed-up for at least 8 weeks. Clinical
characteristics and outcomes were analyzed and compared. In this study, patients'
age, sex, onset location, and durations of disease among 3 groups showed no
significant difference. The resolution rate in group 2 was 72.7% (16/22) for new
patients and 68.8% (22/32) for gross patients, respectively, both of which are
higher than that of group 1 (22.2%, 10/36) but lower than that of group 3 (100%,
36/36). Of group 3, 2 patients received 2 surgical interventions and resolved
finally. Microbiological workup was available in 51 patients. The most common
isolates were staphylococcus species (27.9%) and streptococcus species (20%).
Canalicular laceration developed in 1 patient during the IOI procedure and 1
patient undergoing surgery. Only 2 had postoperative lacrimal pump dysfunction
and 1 had canalicular scarring in group 3. The IOI may be an effective and
minimally invasive technique for treating primary canaliculitis and obviate the
need for further intensive surgery.