RESUMO
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.
Assuntos
Adulto , Idoso , Antibacterianos/uso terapêutico , Bactérias/isolamento & purificação , Cefazolina/uso terapêutico , Doença Crônica , Ciprofloxacina/uso terapêutico , Dacriocistite/tratamento farmacológico , Quimioterapia Combinada , Infecções Oculares Bacterianas/tratamento farmacológico , Infecções Oculares Fúngicas/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Soluções Oftálmicas/uso terapêutico , Estudos RetrospectivosRESUMO
PURPOSE: To study the clinical and histopathological characteristics of uveal melanomas in Asian Indians and compare them with other ethnic groups. MATERIALS AND METHODS: One hundred and three enucleated eyes with clinical diagnosis of uveal melanoma were retrospectively studied (1987-2001) and the clinical and pathological features analysed. RESULTS: Uveal melanomas constituted 0.02% of outpatients in a referral eye hospital in India over a 12-year period. The patients were predominantly males. Uveal melanomas tended to occur in the younger age. The mean age was 45.7 +/- 14.2 years. Melanoma involved the choroid in 90 (87.37%) patients, and both choroid and ciliary body in 13 (12.62%) patients. Mean basal diameter of the tumour was 13.43 +/- 5.32 mm. Mixed cell type was more common. CONCLUSION: Uveal melanomas are rare in the Asian Indians compared to those in the West. They occur in younger persons, have a greater mean basal diameter than that of Caucasians and are predominantly of the mixed cell type.