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To study the outcomes of intracanalicular ointment loading as an outpatient (OP) procedure for management of primary canaliculitis.

This is a prospective, non randomized, minimally invasive case series. Patient demographics, clinical presentations, microbiological profile and clinical outcomes were evaluated. Based on the sensitivity, suitable antibiotic ointment was taken into a 1ml syringe and loaded into the affected canaliculus through 23 gauge blunt cannula (Ciprofloxacin 0.3%, Moxifloxacin 0.5%, or Tobramycin eye ointment 0.3%).

Outcome measures: Complete resolution of canaliculitis with patency of the lacrimal passage.

A total of 24 patients were included in the study, which showed a female preponderance (62.5%, p=0.0424). Mean duration of symptoms was 13.05±14.04 months (range 0.167- 60 months. The incidence of lower canaliculus involvement (14, 58.33%, p=0.022) was significantly higher as compared to the upper (8, 33.33%).

Four patients (16.67%) showed polymicrobial growth on culture, whereas a single organism was identified in 20, 83.33% (p=0.005) cases. Staphylococcus epidermidis and actinomyces israelii (6, 25%) were the most commonly isolated organisms followed by corynebacterium species (4, 16.67%). Mean number of intra canalicular antibiotic loading sessions required was 4.21±1.69 (range 2-8).
Mean duration of follow up was 6.13±6.12 months (range 3-24 months). Complete resolution of canaliculitis was seen in all cases (100%, p<0.0001). At the longest follow up, 21 of 24 patients (87.5% p=0.02)) had patent lacrimal system, one (4.167%) developed common canalicular block. One patient each developed a distal canalicular and a bicanalicular block respectively.Overall successful outcome was seen in 87.5% cases (p=0.0203).

Canalicular ointment loading is a safe, minimally invasive procedure that can easily be done as an outpatient procedure and may obviate the need for interventions like canaliculotomy in cases of recalcitrant canaliculitis.