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Primary canaliculitis: clinical features, microbiological profile, and management outcome.
Ophthalmic Plast Reconstr Surg. 2012 Sep-Oct; 28(5):355-60.OP

Abstract

PURPOSE

To describe the demographic profile, clinical presentation, microbiological profile, and management outcome of primary canaliculitis.

METHODS

Single-center, retrospective, interventional case series. Clinical records of all patients diagnosed with primary canaliculitis and treated at the Department of Ophthalmic Plastic Surgery, LV Prasad Eye Institute, Hyderabad, India, between 1987 and 2010 were reviewed. Retrospective data analysis included demographic profile, clinical presentation, microbiological profile, and management outcomes. The management outcome was further analyzed regarding conservative medical treatment alone, versus punctoplasty with canalicular curettage.

RESULTS

Of the 74 patients, 40 (54%) were women. Mean age at presentation was 48 years. Right eye was involved in 38 (51%) patients, left eye in 34 (46%) patients, and both eyes in 2 (3%) patients. The mean delay in diagnosis was 10 months. Lower canaliculus was involved in 48 (65%) patients, upper canaliculus in 17 (23%) patients, and both canaliculi in 9 (12%) patients. The most common presenting symptom was epiphora, noted in 63 (85%) patients, and the most common clinical sign was thickening of canalicular portion of eyelid seen in 53 (72%) patients. Microbiological workup was available in 54 patients, of whom 49 (91%) yielded positive results. The most common isolate was staphylococcus species in 19 (39%) patients. Conservative medical therapy (punctal dilatation, canalicular expression, and topical antibiotics) resulted in resolution in 35 of 51 (69%) patients, whereas punctoplasty with canalicular curettage resulted in resolution in all 39 (100%) patients. Of the 74 patients, 57 (70%) resolved completely with single intervention, 14 (19%) with 2 interventions, 6 (8%) with 3 interventions, and 2 (3%) with 4 interventions. Recurrence was noted in 2 (3%) patients that subsequently resolved with treatment.

CONCLUSION

Primary canaliculitis is predominantly a unilateral disease with a significant delay in diagnosis. The microbiological profile of canaliculitis is evolving, with staphylococcus species emerging as the most common pathogen. Although conservative medical therapy is beneficial, punctoplasty with canalicular curettage combined with topical antibiotic therapy is the gold standard treatment for canaliculitis.

Authors+Show Affiliations

Department of Ophthalmic Plastic Surgery, LV Prasad Eye Institute, Hyderabad, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22836798

Citation

Kaliki, Swathi, et al. "Primary Canaliculitis: Clinical Features, Microbiological Profile, and Management Outcome." Ophthalmic Plastic and Reconstructive Surgery, vol. 28, no. 5, 2012, pp. 355-60.
Kaliki S, Ali MJ, Honavar SG, et al. Primary canaliculitis: clinical features, microbiological profile, and management outcome. Ophthalmic Plast Reconstr Surg. 2012;28(5):355-60.
Kaliki, S., Ali, M. J., Honavar, S. G., Chandrasekhar, G., & Naik, M. N. (2012). Primary canaliculitis: clinical features, microbiological profile, and management outcome. Ophthalmic Plastic and Reconstructive Surgery, 28(5), 355-60. https://doi.org/10.1097/IOP.0b013e31825fb0cd
Kaliki S, et al. Primary Canaliculitis: Clinical Features, Microbiological Profile, and Management Outcome. Ophthalmic Plast Reconstr Surg. 2012 Sep-Oct;28(5):355-60. PubMed PMID: 22836798.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary canaliculitis: clinical features, microbiological profile, and management outcome. AU - Kaliki,Swathi, AU - Ali,Mohammad Javed, AU - Honavar,Santosh G, AU - Chandrasekhar,Garudadri, AU - Naik,Milind N, PY - 2012/7/28/entrez PY - 2012/7/28/pubmed PY - 2012/12/20/medline SP - 355 EP - 60 JF - Ophthalmic plastic and reconstructive surgery JO - Ophthalmic Plast Reconstr Surg VL - 28 IS - 5 N2 - PURPOSE: To describe the demographic profile, clinical presentation, microbiological profile, and management outcome of primary canaliculitis. METHODS: Single-center, retrospective, interventional case series. Clinical records of all patients diagnosed with primary canaliculitis and treated at the Department of Ophthalmic Plastic Surgery, LV Prasad Eye Institute, Hyderabad, India, between 1987 and 2010 were reviewed. Retrospective data analysis included demographic profile, clinical presentation, microbiological profile, and management outcomes. The management outcome was further analyzed regarding conservative medical treatment alone, versus punctoplasty with canalicular curettage. RESULTS: Of the 74 patients, 40 (54%) were women. Mean age at presentation was 48 years. Right eye was involved in 38 (51%) patients, left eye in 34 (46%) patients, and both eyes in 2 (3%) patients. The mean delay in diagnosis was 10 months. Lower canaliculus was involved in 48 (65%) patients, upper canaliculus in 17 (23%) patients, and both canaliculi in 9 (12%) patients. The most common presenting symptom was epiphora, noted in 63 (85%) patients, and the most common clinical sign was thickening of canalicular portion of eyelid seen in 53 (72%) patients. Microbiological workup was available in 54 patients, of whom 49 (91%) yielded positive results. The most common isolate was staphylococcus species in 19 (39%) patients. Conservative medical therapy (punctal dilatation, canalicular expression, and topical antibiotics) resulted in resolution in 35 of 51 (69%) patients, whereas punctoplasty with canalicular curettage resulted in resolution in all 39 (100%) patients. Of the 74 patients, 57 (70%) resolved completely with single intervention, 14 (19%) with 2 interventions, 6 (8%) with 3 interventions, and 2 (3%) with 4 interventions. Recurrence was noted in 2 (3%) patients that subsequently resolved with treatment. CONCLUSION: Primary canaliculitis is predominantly a unilateral disease with a significant delay in diagnosis. The microbiological profile of canaliculitis is evolving, with staphylococcus species emerging as the most common pathogen. Although conservative medical therapy is beneficial, punctoplasty with canalicular curettage combined with topical antibiotic therapy is the gold standard treatment for canaliculitis. SN - 1537-2677 UR - https://www.unboundmedicine.com/medline/citation/22836798/Primary_canaliculitis:_clinical_features_microbiological_profile_and_management_outcome_ L2 - http://dx.doi.org/10.1097/IOP.0b013e31825fb0cd DB - PRIME DP - Unbound Medicine ER -