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

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.

Clinical Evaluation of Lacrimal Gland Ductal Disease

PURPOSE: To investigate the clinical characteristics and management of lacrimal gland ductal disease, a rare disease often mistaken for other diseases. METHODS: A retrospective chart review of 11 patients (11 eyes, 5 males, 6 females) diagnosed with lacrimal ductal disease between March 2007 and April 2013 was performed. RESULTS: Among 11 eyes in 11 patients, 4 were diagnosed with dacryops and 7 with lacrimal gland ductulitis initiated by dacryolith. The mean age of the subjects was 47.9 years (range, 30-80 years). Lacrimal gland ductulitis patients received treatment for conjunctivitis or hordeolum for several months. Four cases involved the right eye and 7 cases involved the left eye. Symptoms included foreign body sensation, pus-like discharge and palpable mass. Biopsy was performed in 3 cases and showed no specific findings. Patients with dacryops underwent marsupialization, whereas patients diagnosed with lacrimal gland ductulitis underwent excision and dacryolith curettage. During the 2-month follow-up period, all cases showed no signs of recurrence or complications. CONCLUSIONS: Lacrimal gland ductal disease can be mistaken for other diseases such as conjunctivitis, hordeolum, or orbital cyst, thus requiring accurate diagnosis and appropriate management.

Lacrimal Gland Ductulitis: Clinical Features and Management

PURPOSE: To describe the clinical characteristics and management of a group of patients who had infection of the lacrimal gland ductules. METHODS: We performed a retrospective chart review of 12 patients who had infection of the lacrimal gland ductules and were managed at Saevit Eye Hospital from June 2010 to May 2012. RESULTS: The patients' mean age was 31.8 +/- 17.7 years, and 7 were male and 5 were female. Common symptoms were a painful, swelling mass with mucous discharge (8 eyes) and conjunctival injection (4 eyes) at the lateral canthal area. All patients underwent surgical intervention by incision and curettage. Eleven patients (91.7%) had typical sulfur granule of actinomyces, and 8 patients (66.7%) had many cilia in the expressed debris from the ductule. All patients had resolution of symptoms after the procedure and showed no recurrence. CONCLUSIONS: Infective lacrimal gland ductulitis should be considered when a painful swelling mass with mucous discharge at the lateral canthal area is present. Surgical intervention by incision and curettage can be attempted preferentially as a minimally-invasive treatment option.