Department of Ophthalmology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
Acta Ophthalmol. 2011 Dec;89(8):759-63. doi: 10.1111/j.1755-3768.2009.01827.x. Epub 2010 Jan 8.
To analyze the clinical and microbiological characteristics and factors associated with the outcome of lacrimal canaliculitis.
Thirty four patients (34 eyes) treated for lacrimal canaliculitis between January 2001 and December 2006 in a tertiary medical centre were retrospectively reviewed. Clinical and microbiological profiles, treatment outcome, and risk factors related to recurrence and concretions formation were evaluated.
There were 10 males and 24 females with a mean age of 64 years. The average time lapse to diagnosis was 18 months. Lower canaliculus (91%) was most commonly involved. Six patients (18%) had both upper and lower canaliculitis. Culture positive specimens were 21 of 25 (84%), with a mixed infection of 7 (28%). Streptococcus species (28%), Staphylococcus species (20%), and Actinomyces (16%) were the most commonly cultured organisms. Concretions were noted in nine patients (26%). All cultures of concretions were positive. No specific factor was found to be related to concretions formation. Canaliculotomy was performed in 25 patients (74%). Recurrence developed in seven patients (21%), with a mean time to recurrence of 24 months. Multivariate analysis demonstrated that male patients (p=0.038) and presence of concretions (p=0.001) were associated with higher recurrent rate. Both patients with Haemophilus influenzae isolate developed recurrence (100%).
Canaliculitis are often delayed diagnosed and prone to recur or persist. Male gender and concretions are important risk factors for recurrence. Surgical removal of all possible concretions is essential for cure.
分析泪小管炎的临床和微生物学特征及与结局相关的因素。
回顾性分析 2001 年 1 月至 2006 年 12 月在一家三级医疗中心治疗的 34 例（34 眼）泪小管炎患者。评估了临床和微生物特征、治疗结果以及与复发和结石形成相关的危险因素。
男性 10 例，女性 24 例，平均年龄 64 岁。确诊的平均时间间隔为 18 个月。下泪小管（91%）最常受累。6 例（18%）患者同时患有上、下泪小管炎。25 例标本中培养阳性者 21 例（84%），混合感染 7 例（28%）。培养出的最常见病原体为链球菌属（28%）、葡萄球菌属（20%）和放线菌属（16%）。9 例（26%）患者有结石。所有结石培养均为阳性。未发现结石形成的特定相关因素。25 例（74%）患者行泪小管切开术。7 例（21%）患者复发，复发平均时间为 24 个月。多变量分析表明，男性患者（p=0.038）和存在结石（p=0.001）与更高的复发率相关。分离出流感嗜血杆菌的 2 例患者均复发（100%）。
泪小管炎常延迟诊断，且易复发或持续存在。男性性别和结石是复发的重要危险因素。彻底清除所有可能的结石是治愈的关键。
