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A case report on complete cure of recurrent primary canaliculitis by 4-snip punctoplasty and canalicular curettage.
Medicine (Baltimore) 2018; 97(49):e13508M

Abstract

RATIONALE

For the treatment of primary canaliculitis, 1,2,3-snip punctoplasty and canalicular curettage are commonly used; however, a recurrence rate of 6.6% to 22% has been reported. Herein, we describe a case of recurrent primary canaliculitis that was completely cured by 4-snip punctoplasty and canalicular curettage.

PATIENT CONCERNS

A 53-year-old woman was admitted to our hospital with chief complaints of epiphora, discharge, eyelid flare up, and swelling near the inferior lacrimal punctum in the left eye, which initially presented 6 months earlier.

DIAGNOSIS

Based on the aforementioned symptoms, the patient was initially diagnosed with bacterial conjunctivitis at a local ophthalmologic clinic and used antibiotic eye drops for 6 months. However, her symptoms did not improve and they worsened at 2 weeks prior to admission. She was subsequently diagnosed with chronic dacryocystitis and referred to our hospital for surgical treatment. Slit lamp examination results showed conjunctival congestion in the inner corner of the left eye, along with eyelid flare up, swelling near the inferior lacrimal punctum, and yellowish discharge and concretion from the lacrimal punctal orifice. Furthermore, punctal regurgitation was not observed in the lacrimal sac compression test. Thus, the patient was diagnosed with primary canaliculitis on the basis of her clinical symptoms and laboratory findings.

INTERVENTIONS

Based on the diagnosis of primary canaliculitis, 1-snip punctoplasty and canalicular curettage were performed, and the patient was prescribed oral antibiotics for 2 weeks together with topical antibiotics for 4 weeks. Overall, the patient's symptoms improved after surgery, but epiphora and yellowish discharge from the lacrimal punctal orifice developed again 2 months after surgery during outpatient follow-up. Based on the diagnosis of recurrent primary canaliculitis, 4-snip punctoplasty and canalicular curettage were performed, and the patient was prescribed oral antibiotics for 2 weeks together with topical antibiotics for 4 weeks.

OUTCOMES

Over a 6-month follow-up period, the symptoms disappeared completely and no other findings were observed.

LESSONS

Four-snip punctoplasty and canalicular curettage are simple clinical procedures that can minimize the recurrence rate of primary canaliculitis. Hence, 4-snip punctoplasty and canalicular curettage should be considered as the 1st-line treatment for primary canaliculitis and recurrent cases.

Authors+Show Affiliations

Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.No affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

30544448

Citation

Kim, Min Ho, and Ho Ra. "A Case Report On Complete Cure of Recurrent Primary Canaliculitis By 4-snip Punctoplasty and Canalicular Curettage." Medicine, vol. 97, no. 49, 2018, pp. e13508.
Kim MH, Ra H. A case report on complete cure of recurrent primary canaliculitis by 4-snip punctoplasty and canalicular curettage. Medicine (Baltimore). 2018;97(49):e13508.
Kim, M. H., & Ra, H. (2018). A case report on complete cure of recurrent primary canaliculitis by 4-snip punctoplasty and canalicular curettage. Medicine, 97(49), pp. e13508. doi:10.1097/MD.0000000000013508.
Kim MH, Ra H. A Case Report On Complete Cure of Recurrent Primary Canaliculitis By 4-snip Punctoplasty and Canalicular Curettage. Medicine (Baltimore). 2018;97(49):e13508. PubMed PMID: 30544448.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A case report on complete cure of recurrent primary canaliculitis by 4-snip punctoplasty and canalicular curettage. AU - Kim,Min Ho, AU - Ra,Ho, PY - 2018/12/15/entrez PY - 2018/12/14/pubmed PY - 2019/1/1/medline SP - e13508 EP - e13508 JF - Medicine JO - Medicine (Baltimore) VL - 97 IS - 49 N2 - RATIONALE: For the treatment of primary canaliculitis, 1,2,3-snip punctoplasty and canalicular curettage are commonly used; however, a recurrence rate of 6.6% to 22% has been reported. Herein, we describe a case of recurrent primary canaliculitis that was completely cured by 4-snip punctoplasty and canalicular curettage. PATIENT CONCERNS: A 53-year-old woman was admitted to our hospital with chief complaints of epiphora, discharge, eyelid flare up, and swelling near the inferior lacrimal punctum in the left eye, which initially presented 6 months earlier. DIAGNOSIS: Based on the aforementioned symptoms, the patient was initially diagnosed with bacterial conjunctivitis at a local ophthalmologic clinic and used antibiotic eye drops for 6 months. However, her symptoms did not improve and they worsened at 2 weeks prior to admission. She was subsequently diagnosed with chronic dacryocystitis and referred to our hospital for surgical treatment. Slit lamp examination results showed conjunctival congestion in the inner corner of the left eye, along with eyelid flare up, swelling near the inferior lacrimal punctum, and yellowish discharge and concretion from the lacrimal punctal orifice. Furthermore, punctal regurgitation was not observed in the lacrimal sac compression test. Thus, the patient was diagnosed with primary canaliculitis on the basis of her clinical symptoms and laboratory findings. INTERVENTIONS: Based on the diagnosis of primary canaliculitis, 1-snip punctoplasty and canalicular curettage were performed, and the patient was prescribed oral antibiotics for 2 weeks together with topical antibiotics for 4 weeks. Overall, the patient's symptoms improved after surgery, but epiphora and yellowish discharge from the lacrimal punctal orifice developed again 2 months after surgery during outpatient follow-up. Based on the diagnosis of recurrent primary canaliculitis, 4-snip punctoplasty and canalicular curettage were performed, and the patient was prescribed oral antibiotics for 2 weeks together with topical antibiotics for 4 weeks. OUTCOMES: Over a 6-month follow-up period, the symptoms disappeared completely and no other findings were observed. LESSONS: Four-snip punctoplasty and canalicular curettage are simple clinical procedures that can minimize the recurrence rate of primary canaliculitis. Hence, 4-snip punctoplasty and canalicular curettage should be considered as the 1st-line treatment for primary canaliculitis and recurrent cases. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/30544448/A_case_report_on_complete_cure_of_recurrent_primary_canaliculitis_by_4-snip_punctoplasty_and_canalicular_curettage L2 - http://Insights.ovid.com/pubmed?pmid=30544448 DB - PRIME DP - Unbound Medicine ER -