Chronic suppurative lacrimal canaliculitis is an important cause
of ocular surface discomfort. Treatment with topical antibiotics
is often inadequate and surgical treatment by canaliculotomy
and canalicular curettage has been the mainstay of treatment
in the past. The role of canalicular antibiotic irrigation has
been inadequately studied. We report the clinical features,
microbiological profile and treatment outcome in a series of
12 patients with suppurative lacrimal canaliculitis. Two patients
had Actinomyces infection, five had Nocardia infection and
seven patients had polymicrobial infection. Three patients had
resolution of canaliculitis on combination broad-spectrum topical
antibiotic therapy using ciprofloxacin and fortified cefazolin.
In nine patients, topical antibiotic therapy was combined with
canalicular irrigation using fortified cefazolin. All patients had
excellent resolution of canaliculitis without the need for surgical
treatment. Availability of broad-spectrum antibiotics and
canalicular irrigation may offer an alternative to surgery in the
management of suppurative lacrimal canaliculitis.
The identification of potential risk factors in a given eye can alert the surgeon to the possibility of development of anterior chamber collapse postoperatively.
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