Clinical characteristics and factors associated the outcome of lacrimal canaliculitis.
OBJECTIVE
To analyze the clinical and microbiological characteristics and factors associated with the outcome of lacrimal canaliculitis.


METHODS
Thirty four patients (34 eyes) treated for lacrimal canaliculitis between January 2001 and December 2006 in a tertiary medical centre were retrospectively reviewed. Clinical and microbiological profiles, treatment outcome, and risk factors related to recurrence and concretions formation were evaluated.


RESULTS
There were 10 males and 24 females with a mean age of 64 years. The average time lapse to diagnosis was 18 months. Lower canaliculus (91%) was most commonly involved. Six patients (18%) had both upper and lower canaliculitis. Culture positive specimens were 21 of 25 (84%), with a mixed infection of 7 (28%). Streptococcus species (28%), Staphylococcus species (20%), and Actinomyces (16%) were the most commonly cultured organisms. Concretions were noted in nine patients (26%). All cultures of concretions were positive. No specific factor was found to be related to concretions formation. Canaliculotomy was performed in 25 patients (74%). Recurrence developed in seven patients (21%), with a mean time to recurrence of 24 months. Multivariate analysis demonstrated that male patients (p=0.038) and presence of concretions (p=0.001) were associated with higher recurrent rate. Both patients with Haemophilus influenzae isolate developed recurrence (100%).


CONCLUSIONS
Canaliculitis are often delayed diagnosed and prone to recur or persist. Male gender and concretions are important risk factors for recurrence. Surgical removal of all possible concretions is essential for cure.
Lin
Shuai-Chun
SC
Department of Ophthalmology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
Kao
Shu-Ching
SC
Tsai
Chieh-Chih
CC
Cheng
Ching-Yu
CY
Kau
Hui-Chuan
HC
Hsu
Wen-Ming
WM
Lee
Shu-Mei
SM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000302:isolation & purification; D003607:Dacryocystitis / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome