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Vertical canaliculotomy with retrograde expression of concretions for the treatment of canaliculitis.
Ophthalmic Plast Reconstr Surg. 2015 Mar-Apr; 31(2):119-21.OP

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.

Authors+Show Affiliations

Lions Eye Institute, Albany Medical Center, Slingerlands, New York, U.S.A.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24978426

Citation

Perumal, Balaji, and Dale R. Meyer. "Vertical Canaliculotomy With Retrograde Expression of Concretions for the Treatment of Canaliculitis." Ophthalmic Plastic and Reconstructive Surgery, vol. 31, no. 2, 2015, pp. 119-21.
Perumal B, Meyer DR. Vertical canaliculotomy with retrograde expression of concretions for the treatment of canaliculitis. Ophthalmic Plast Reconstr Surg. 2015;31(2):119-21.
Perumal, B., & Meyer, D. R. (2015). Vertical canaliculotomy with retrograde expression of concretions for the treatment of canaliculitis. Ophthalmic Plastic and Reconstructive Surgery, 31(2), 119-21. https://doi.org/10.1097/IOP.0000000000000213
Perumal B, Meyer DR. Vertical Canaliculotomy With Retrograde Expression of Concretions for the Treatment of Canaliculitis. Ophthalmic Plast Reconstr Surg. 2015 Mar-Apr;31(2):119-21. PubMed PMID: 24978426.
* Article titles in AMA citation format should be in sentence-case
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 - http://dx.doi.org/10.1097/IOP.0000000000000213 DB - PRIME DP - Unbound Medicine ER -