View 2019 Abstracts

Title Canalicular Antibiotic Ointment Loading: Primary Management option for management of Canaliculitis
Submitted by Sonam Nisar
Abstract Number 104
Review Result rapid fire presentation
Purpose

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

Methods

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.

Results

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).

Conclusion

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.


Additional Authors
Last name Initials City / Hospital Department
Alam Shahid Kolkata / Sankara Nethralaya Orbit and Oculoplasty
Mukherjee Bipasha Chennai/ Sankara Nethralaya Orbit and Oculoplasty