title: Clinical features, microbiological profiles and treatment outcome of lacrimal plug-related canaliculitis compared with those of primary canaliculitis.
abstract: OBJECTIVE
  To compare the clinical features and treatment outcome between lacrimal plug-related canaliculitis and primary canaliculitis.
  
  
  METHODS
  Patients with plug-related canaliculitis and primary canaliculitis between 2007 and 2014 in a medical centre were collected. Charts were reviewed for clinical features, microbiological profiles, time lapse between plug insertion and symptom onset, type of plug and outcomes.
  
  
  RESULTS
  Of 76 eligible cases collected, 13 were plug-related canaliculitis and 63 were primary canaliculitis. The most common presenting symptom was discharge in both groups (85% and 79%, respectively). The average time interval from plug insertion to symptoms onset was 5.5 years. Most canaliculitis developed in women, especially for plug-related canaliculitis, when compared with primary canaliculitis (100% vs 65.1%; p=0.015). The most common isolated microorganism was Pseudomonas aeruginosa in plug-related canaliculitis (46%) and Streptococcus in primary canaliculitis (28%), respectively. Isolation of Pseudomonas was significantly higher in plug-related canaliculitis than in primary canaliculitis (46% vs 12%; p=0.029). Most plug-related canaliculitis resolved after removal of plugs by canaliculotomy (12 cases, 93%). Most identified plug was SmartPlug (seven cases), followed by EaglePlug (two cases) and Herrick Lacrimal Plug (two cases). There was no recurrence in patients with plug-related canaliculitis, however, recurrence developed in seven patients (11%) with primary canaliculitis.
  
  
  CONCLUSIONS
  In comparison with primary canaliculitis, plug-related canaliculitis appear to be more prevalent in women and show a different microbiological profile. Retrieval of infected plug by canaliculotomy and adequate antibiotics can achieve a good outcome. Long-term follow-up is required because canaliculitis may develop several years after plug insertion.
authors.affiliation: Department of Ophthalmology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yu-Yun
authors.initials: YY
authors.lastname: Huang
authors.affiliation: Department of Ophthalmology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
authors.forename: Wei-Kuang
authors.initials: WK
authors.lastname: Yu
authors.affiliation: Department of Ophthalmology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chieh-Chih
authors.initials: CC
authors.lastname: Tsai
authors.affiliation: Department of Ophthalmology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
authors.forename: Shu-Ching
authors.initials: SC
authors.lastname: Kao
authors.affiliation: Department of Ophthalmology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan.
authors.forename: Hui-Chuan
authors.initials: HC
authors.lastname: Kau
authors.affiliation: Department of Ophthalmology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
authors.forename: Catherine Jui-Ling
authors.initials: CJ
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000302:isolation & purification*; D000069282:Canaliculitis / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D003607:Dacryocystitis / Q000601:surgery*; D020878:Device Removal / Q000379:methods*; D015818:Eye Infections, Bacterial / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Infection; Lacrimal drainage; Microbiology; Tears