Outcomes of canaliculotomy in recalcitrant canaliculitis

Abstract

Purpose: To evaluate outcomes of canaliculotomy in cases of recalcitrant canaliculitis. Methods: All cases diagnosed with canaliculitis who subsequently underwent canaliculotomy over a 15 year period were included in the study. We reviewed and analyzed demographic data, clinical presentation, microbiological profile and management outcomes. Results: Out of 40 patients, 21 (52.5%) were males. Age range was 17–89 years. Lower canaliculus was affected most commonly (53.81%). Mean duration of symptoms was 8 months (range- 0.5–60 months, median 6 months). The most common presenting symptom was watering (34, 85%) while pouting puncta (32, 80%) was the most frequently documented clinical sign. Concretions were seen in 20 (50%) patients and Actinomyces was the most commonly isolated micro organism in the concretion group. Polymicrobial growth was seen in 18 (45%) patients. Commonly isolated bacteria on culture were Staphylococcus epidermidis (16, 40%) followed by Actinomyces (14, 34%) and Corynebacterium species (5, 12.5%). Complete resolution was seen in 39 cases post-operatively (97.5%, p = 0.0002). Mean follow up period was 21 months (range- 3–180 months). Recurrence was noted in 6(15%) cases, of which 4 were males (66.67%, p = 0.069) Four (66.67%, p = 0.069) patients had associated diabetes and 5 (83.33%, p = 0.046) had associated concretions. Six (15%) patients complained of persistent epiphora. Conclusion: Canaliculotomy is a safe and effective method for management of recalcitrant canaliculitis with a success rate of 85%. Presence of concretions was associated with higher risk of recurrence in our study.