title: Controversies of the lacrimal system.
abstract: Numerous long-standing controversies influence the management of lacrimal sac abscesses, canalicular lacerations, and obstruction of the nasolacrimal duct. We examined the debatable beliefs that underline these controversies and concluded the following: drainage of a pointing lacrimal sac abscess can be well tolerated under local anesthesia, is associated with few adverse events, and should be performed regardless of whether systemic antibiotics have been administered. Reconstruction of monocanalicular lacerations should be considered in all cases, without distinction to whether the injury involves the upper or lower canaliculus. Finally, no firm evidence currently exists supporting intubation with routine dacryocystorhinostomy.
authors.affiliation: Department of Ophthalmology, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Evan
authors.initials: E
authors.lastname: Kalin-Hajdu
authors.affiliation: Department of Ophthalmology, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Cadet
authors.affiliation: Department of Ophthalmology, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada. Electronic address: info@cliniqueo.com.
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Boulos
mesh_terms: D000038:Abscess / Q000209:etiology / Q000601:surgery*; D003608:Dacryocystorhinostomy; D004322:Drainage; D005131:Eye Injuries / Q000601:surgery; D006801:Humans; D007440:Intubation; D022125:Lacerations / Q000601:surgery; D007765:Lacrimal Apparatus / Q000293:injuries; D007766:Lacrimal Apparatus Diseases / Q000209:etiology / Q000601:surgery*; D007767:Lacrimal Duct Obstruction / Q000209:etiology / Q000628:therapy; D015607:Stents
keywords: canalicular laceration; dacryocystorhinostomy; lacrimal apparatus; lacrimal duct obstruction; lacrimal sac abscess; stenting