J Korean Ophthalmol Soc.  2015 Nov;56(11):1798-1803. 10.3341/jkos.2015.56.11.1798.

Two Cases of Skin Necrosis after Canaliculodacryocystorhinostomy in Young Women

• Cho EY
• Son JH

• KMID: 2214191
• DOI: http://doi.org/10.3341/jkos.2015.56.11.1798

Abstract

PURPOSE
To report 2 cases of skin necrosis over the medial canthus following canaliculodacryocystorhinostomy in young women diagnosed with canalicular obstruction.
CASE SUMMARY
(Case 1) A 31-year-old female presented to our clinic with epiphora in the right eye that had developed 2 years prior. On examination, a right upper and lower canalicular obstruction was noted and the patient underwent canaliculodacryocystorhinostomy with silicone tube intubation. Topical 0.04% mitomycin-C eyedrops were applied twice a day from postoperative day 1 for 7 days. The patient revisited our emergency center with swelling, redness, and tenderness in the medial canthal region that developed 3 days after the initial surgery. Furthermore, a skin ulceration had developed followed by an exudative oozing with crust. (Case 2) A 23-years-old female visited our clinic with epiphora in the right eye that had developed 3 months prior. Ophthalmic examinations revealed a common canalicular obstruction in the right eye and canaliculodacryocystorhinostomy with silicone tube intubation was performed. Seven days postoperatively, the patient developed mild pain and tenderness over the right lacrimal sac and medial canthal erythema with purulent discharge was noted. Furthermore, a localized skin necrosis had developed.
CONCLUSIONS
Localized skin necrosis may rarely develop after canaliculodacryocystorhinostomy in young women. If localized skin symptoms develop postoperatively, the patient should be closely monitored.

Keyword

Canalicular obstruction; Canaliculodacryocystorhinostomy; Medial canthus; Skin necrosis

MeSH Terms

Adult
Emergencies
Erythema
Female
Humans
Intubation
Lacrimal Apparatus Diseases
Mitomycin
Necrosis*
Ophthalmic Solutions
Silicones
Skin Ulcer
Skin*
Mitomycin
Ophthalmic Solutions
Silicones

Figure

• 

  Figure 1. Case 1. External photograph of the 31 year-old woman. (A) After 1 week canaliculodacryocystorhinostomy, the right low-er and medial canthal region was developed with swelling, redness, and tenderness. (B) At 2 weeks following the surgery, skin ne-crosis with crust (C) and at 3 weeks, exudative oozing was demonstrated. (D) At the most recent observation at 5 months, the skin necrosis and scar almostly had improved.

• 

  Figure 2. Case 2. External photograph of the 23 year-old woman. (A) After 1 week canaliculodacryocystorhinostomy, the patient was developed with mild pain and lid swelling over the right medial canthal region. (B) By 2 weeks, erythema and severe lid swelling with localized tissue necrosis was noted. (C) By 3 weeks, lid swelling and tenderness was decreased. (D) And at the most recent visit at 3 months, the skin necrosis was much improved.

Reference

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