Evaluation of granulation tissue formation in lacrimal duct post silicone intubation and its successful management by injection of prednisolone acetate ointment into the lacrimal duct.
OBJECTIVE
To evaluate the clinical findings and original treatment method of granulation tissue formation post silicone intubation (SI) for primary acquired lacrimal drainage obstruction (PALDO).


METHODS
This retrospective, consecutive, comparative, interventional case series study involved 85 consecutive PALDO patients treated by SI and followed by dacryoendoscopy for 12 months post surgery. Patients in whom complication by granulation tissue formation occurred were treated every 2 weeks until it disappeared with an injection of prednisolone acetate ophthalmic ointment into the lacrimal duct without removing the tube. The frequency of granulation tissue formation post SI, relationship between the locations where the primary obstruction and granulation tissue formation occurred, and impact of the complication on the surgical outcome were evaluated.


RESULTS
Granulation tissue formation occurred in 9 of the 85 cases (10.6 %) at 2-8 weeks post surgery, yet disappeared via treatment during that same period. No relationship was found between the location of the primary obstruction and the granulation tissue formation, and no statistical difference was found when comparing the success rate of our surgical treatment in patients with or without the complication (P = 0.46, Fisher's exact test).


CONCLUSIONS
Complication by granulation tissue formation occurred in 10.6 % of the patients who underwent SI for PALDO, yet the injection of prednisolone acetate ophthalmic ointment into the lacrimal passage may have successfully treated the complication without removal of the silicone tube.
Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan. opt119@poh.osaka-med.ac.jp.|Department of Ophthalmology, Osaka Kaisei Hospital, Osaka City, Osaka, Japan. opt119@poh.osaka-med.ac.jp.
Masashi
M
Mimura
Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
Mari
M
Ueki
Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
Hidehiro
H
Oku
Department of Ophthalmology, Osaka Kaisei Hospital, Osaka City, Osaka, Japan.
Bunpei
B
Sato
Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
Tsunehiko
T
Ikeda
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003608:Dacryocystorhinostomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006097:Granulation Tissue / Q000000981:diagnostic imaging*; D006801:Humans; D007440:Intubation / Q000379:methods; D007767:Lacrimal Duct Obstruction / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000000981:diagnostic imaging / Q000601:surgery*; D009824:Ointments / Q000008:administration & dosage; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011239:Prednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D012189:Retrospective Studies; D012828:Silicones / Q000008:administration & dosage*; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D009824:Ointments; D012828:Silicones; C009935:prednisolone acetate; D011239:Prednisolone
Granulomatous proliferation; Intubation; Lacrimal duct obstruction; Silicone