J Korean Ophthalmol Soc.  2010 Jun;51(6):890-894. 10.3341/jkos.2010.51.6.890.

Two Cases of Lacrimal Drainage Obstruction Associated With S-1 Anticancer Treatment

• Park JS
• Ha SW
• Lew H

• KMID: 2213626
• DOI: http://doi.org/10.3341/jkos.2010.51.6.890

Abstract

PURPOSE
To report two cases of lacrimal drainage obstruction associated with the anticancer drug S-1 (tegafur, gimeracil, oteracil ; TS-1(R), Taiho Pharmaceutical, Japan).
CASE SUMMARY
(Case 1) A 34-year-old male who had previously undergone a total gastrectomy for treatment of gastric cancer visited with epiphora in both eyes that had developed 6 months after S-1 treatment. On examination, a right canalicular obstruction and left punctal and nasolacrimal partial obstruction were noted. Endoscopic dacrycystorhinostomy with lacrimal trephinization was done in the right eye and punctoplasty with punctal membrane removal and silicone tube intubation were performed in the left eye and the epiphora were successfully treated. (Case 2) A 60-year-old male who was treated with S-1 for gastric cancer presented with tearing in both eyes that had developed 2 months after S-1 treatment. Ophthalmic examinations revealed a right nasolacrimal partial obstruction in the right eye and lacrimal sac obstruction in the left. Silicone intubations were performed on both sides and the epiphora were successfully treated.
CONCLUSIONS
Lacrimal drainage obstructions may develop after S-1 treatment. Therefore, ophthalmologic evaluations should be performed in patients treated with S-1 to detect lacrimal drainage obstruction.

Keyword

Epiphora; Lacrimal drainage obstruction; S-1

MeSH Terms

Adult
Drainage
Eye
Gastrectomy
Humans
Intubation
Lacrimal Apparatus Diseases
Male
Membranes
Middle Aged
Oxonic Acid
Pyridines
Silicones
Stomach Neoplasms
Tears
Oxonic Acid
Pyridines
Silicones

Figure

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  Figure 1. Preoperative photographs of case 1 patient show left (A) upper and (B) lower punctal stenosis.

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  Figure 2. Preoperative macro digital subtraction dacryocystographic findings of case 1 patient show (A) right canalicular obstruction and (B) left nasolacrimal duct partial obstruction.

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  Figure 3. (A) Histopathologic findings of punctal membrane (case 1) show subepithelial fibrosis (white arrow) be-low stratified squamous epithelium (black arrow) (hematoxylin-eosin, ×200) (B) Histopathologic findings of lacrimal sac (case 1) show chronic inflammation consisting of lymphocytes (black arrow) with fibrosis (white arrow) (hematoxylin-eosin, ×200).

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  Figure 4. Preoperative macro digital subtraction dacryocystographic findings of case 2 patient show (A) right nasolacrimal duct partial obstruction and (B) left lacrimal sac obstruction.

Reference

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