Abstract
PURPOSE
To evaluate the efficacy and safety of the technique of vertical canaliculotomy with retrograde expression of concretions for the treatment of canaliculitis.
METHODS
This is a retrospective, interventional case series. Patients who underwent vertical canaliculotomy by 1 surgeon (D.R.M.) from August 2011 to December 2013 were identified. On initial diagnosis of canaliculitis, all patients were treated with a combination antibiotic/steroid eyedrop and an oral antibiotic. The procedure was performed 1 month later and consisted of a 2-mm vertical canaliculotomy with sharp-tipped scissors followed by retrograde expression of the canalicular contents by compressing the canaliculus medial to lateral with 2 cotton-tipped applicators. All concretion specimens were sent for pathologic examination. Pre- and postoperative subjective complaints and objective findings on examination, including eyelid thickening and probing/irrigation results, were recorded.
RESULTS
Canalicular contents were readily expressed from all 8 patients who underwent the procedure. Pathologic analysis revealed Actinomyces species in 5 of 8 specimens and other Gram-negative and Gram-positive bacteria in the remaining specimens. All patients reported significant improvement in their symptoms and were patent to irrigation.
CONCLUSIONS
Many reported surgical procedures for the treatment of canaliculitis involve the use of a curette, an instrument with sharp edges, that could potentially damage the lining of the canaliculus. Previous studies examining these procedures have reported canalicular stricture and dysfunction postoperatively. The current technique of vertical canaliculotomy with retrograde expression of canalicular contents described herein has been effective, limits iatrogenic trauma, and had a low incidence of postoperative complications in this series.
TY - JOUR
T1 - Vertical canaliculotomy with retrograde expression of concretions for the treatment of canaliculitis.
AU - Perumal,Balaji,
AU - Meyer,Dale R,
PY - 2014/7/1/entrez
PY - 2014/7/1/pubmed
PY - 2015/10/10/medline
SP - 119
EP - 21
JF - Ophthalmic plastic and reconstructive surgery
JO - Ophthalmic Plast Reconstr Surg
VL - 31
IS - 2
N2 - PURPOSE: To evaluate the efficacy and safety of the technique of vertical canaliculotomy with retrograde expression of concretions for the treatment of canaliculitis. METHODS: This is a retrospective, interventional case series. Patients who underwent vertical canaliculotomy by 1 surgeon (D.R.M.) from August 2011 to December 2013 were identified. On initial diagnosis of canaliculitis, all patients were treated with a combination antibiotic/steroid eyedrop and an oral antibiotic. The procedure was performed 1 month later and consisted of a 2-mm vertical canaliculotomy with sharp-tipped scissors followed by retrograde expression of the canalicular contents by compressing the canaliculus medial to lateral with 2 cotton-tipped applicators. All concretion specimens were sent for pathologic examination. Pre- and postoperative subjective complaints and objective findings on examination, including eyelid thickening and probing/irrigation results, were recorded. RESULTS: Canalicular contents were readily expressed from all 8 patients who underwent the procedure. Pathologic analysis revealed Actinomyces species in 5 of 8 specimens and other Gram-negative and Gram-positive bacteria in the remaining specimens. All patients reported significant improvement in their symptoms and were patent to irrigation. CONCLUSIONS: Many reported surgical procedures for the treatment of canaliculitis involve the use of a curette, an instrument with sharp edges, that could potentially damage the lining of the canaliculus. Previous studies examining these procedures have reported canalicular stricture and dysfunction postoperatively. The current technique of vertical canaliculotomy with retrograde expression of canalicular contents described herein has been effective, limits iatrogenic trauma, and had a low incidence of postoperative complications in this series.
SN - 1537-2677
UR - https://www.unboundmedicine.com/medline/citation/24978426/Vertical_canaliculotomy_with_retrograde_expression_of_concretions_for_the_treatment_of_canaliculitis_
L2 - https://doi.org/10.1097/IOP.0000000000000213
DB - PRIME
DP - Unbound Medicine
ER -