Korean J Ophthalmol.  2019 Dec;33(6):487-492. 10.3341/kjo.2019.0013.

Long-term Outcome of Incision and Curettage Treatment in Patients with Lacrimal Gland Ductulitis

Affiliations
  • 1Department of Ophthalmology, Saevit Eye Hospital, Goyang, Korea. szera0306@saeviteye.com

Abstract

PURPOSE
To describe the effects and long-term outcomes of incision and curettage treatment in patients with lacrimal gland ductulitis.
METHODS
Twenty-four patients (24 eyes) with lacrimal gland ductulitis who were treated at Saevit Eye Hospital from June 2010 to November 2016. All patients underwent incision and curettage through the lacrimal ductule, and granules or concretions were removed. After the procedure, oral and topical antibiotics, oral anti-inflammatory agent were used for a week. Clinical presentations of the patients were analyzed. The resolution of symptoms and inflammatory signs and recurrence were evaluated more than 12 months after the procedure including telephone follow-up by a specialist nurse.
RESULTS
Common symptoms were a painful, swelling mass with mucous discharge (17 eyes) and conjunctival injection (7 eyes) at the lateral canthal area. During the procedure, 22 patients (91.7%) had typical sulfur granule of Actinomyces, and 10 patients (41.7%) had many cilia in the expressed debris from the ductule. Twenty-three of 24 patients had resolution of symptoms after the procedure and all but one patient (95.8%) showed no recurrence.
CONCLUSIONS
Incision and curettage is a simple and less invasive procedure that may be considered as a first treatment option for lacrimal gland ductulitis. Furthermore, incision and curettage of the affected lacrimal ductule has been shown to be effective at minimizing long-term recurrence of lacrimal ductulitis.

Keyword

Actinomyces; Curettage; Lacrimal apparatus; Lacrimal gland ductulitis

MeSH Terms

Actinomyces
Anti-Bacterial Agents
Cilia
Curettage*
Follow-Up Studies
Humans
Lacrimal Apparatus*
Recurrence
Specialization
Sulfur
Telephone
Anti-Bacterial Agents
Sulfur

Figure

  • Fig. 1 Patient with lacrimal gland ductulitis underwent incision and curettage. (A) An extended wall of the lacrimal gland ductile was incision and expanded using a Westcott stitch scissors (Katena K4-4100). (B) A Meyerhoefer chalazion curette 1.75 mm (Stephens S4-1005) was inserted into the lacrimal gland ductule and removed until no more contents. (C) Sulfur granules are suspected.Informed consent was obtained from all study participants.

  • Fig. 2 Patient with lacrimal gland ductulitis and dacryolith. (A) Patient with lacrimal gland ductulitis referred with painful lid swelling, persistent temporal conjunctival injection, and chronic mucopurulent discharge from the lacrimal gland ductule. (B) Many cilia in the expressed debris from the affected ductule. Informed consent was obtained from the study participant.


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