Punctal and canalicular stenosis associated with systemic fluorouracil therapy. Report of five cases and review of the literature.
Ocular side effects of systemic fluorouracil include excessive lacrimation, due to punctal and canalicular stenosis and fibrosis. Obstruction of the tear ducts after systemic therapy with fluorouracil is more frequent than is assumed. Five patients with breast cancer and punctal or canalicular stenosis are presented. Although complaints of epiphora usually resolve two weeks after cessation of systemic therapy, local antibiotics and steroids may be indicated. In patients with persisting complaints, and patients treated with fluorouracil for a prolonged period of time, prophylactic intubation of the tear ducts with silastic tubes has been advocated. (Conjunctivo)dacryocystorhinostomy may be unavoidable.
Institute of Ophthalmology, Nijmegen University Hospital, The Netherlands.
H M
HM
Brink
L V
LV
Beex
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D005260:Female; D005355:Fibrosis / Q000139:chemically induced; D005472:Fluorouracil / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007765:Lacrimal Apparatus / Q000187:drug effects / Q000378:metabolism; D007767:Lacrimal Duct Obstruction / Q000139:chemically induced*; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000187:drug effects*
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil