Journal List > J Korean Ophthalmol Soc > v.52(7) > 1009077

Park, Chang, and Lee: Clinical Study on Acute Conjunctivitis after Endoscopic Dacryocystorhinostomy with Silicone Tube Intubation

Abstract

Purpose

To investigate the incidence and clinical course of acute conjunctivitis after endoscopic dacryocystorhinostomy (DCR) with silicone tube intubation.

Methods

A retrospective study was conducted on 547 eyes in 517 patients who had undergone endoscopic DCR with silicone tube intubation between 2005 and 2009. The onset, incidence and symptoms of acute conjunctivitis, the effect of silicone tube intubation on acute conjunctivitis, and the effect of acute conjunctivitis on the success rate of DCR were investigated.

Results

The incidence of acute conjunctivitis was 3.8%. The mean age of 21 patients with acute conjunctivitis was 52.6 ± 14.3 years and the mean follow-up period of those was 18.0 ± 6.4 months after surgery. All the cases of acute conjunctivitis were resolved with topical antibiotic treatment after silicone tube removal. The success rates between patients with and without conjunctivitis were not significantly different (80.95% and 88.97%, respectively; p = 0.282). However, 4 patients with surgical failure had a longer time from onset of acute conjunctivitis to the removal of the silicone tube than 17 patients with surgical success (0.22 months and 1.13 months, respectively; p = 0.047). A higher rate (76.2%) of conjunctivitis developed in patients with granuloma around the surgical ostium.

Conclusions

A correlation may exist between acute conjunctivitis and granuloma in patients with DCR with silicone tube intubation. Acute conjunctivitis did not appear to influence the surgical results, although a delayed timing of silicone tube removal in patients with conjunctivitis could decrease the success rate.

References

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Figure 1.
(A) Acute conjunctivitis after DCR. (B) Viral conjunctivitis.
jkos-52-794f1.tif
Table 1.
Characteristics of patients with and without acute conjunctivitis after endonasal dacryocystorhinostomy with silicone tube intubation
  Acute conjunctivitis p-value*
(+) (n = 21) (−) (n = 526)
Age (mean ± SD, yr) 52.6 ± 14.3 54.2 ± 16.2 0.648*
Sex (M:F) 6:15 126:400 0.604
Follow-up period (mean ± SD, mon) 18.0 ± 6.4 20.1 ± 9.1 0.392*
Tube removal (mean ± SD, mon [range]) 3.6 ± 1.0 (1.75–5.5) 5.9 ± 0.2 (5.0–6.0) <0.001*

* p-value for Mann-Whitney test

p-value for Fisher exact test.

Table 2.
Timings of silicone tube removal and success rates according to onset of acute conjunctivitis after endonasal dacryocystorhinostomy
  Onset of acute conjunctivitis after endonasal DCR p-value
<3 mon (n = 6) >3 mon (n = 15)
Tube removal (mean ± SD, mon)* 0.83 ± 0.75 0.22 ± 0.28 0.106
Success rates (% [eye]) 66.7 (4/6) 86.7 (13/15) 0.544

* Period from onset of acute conjunctivitis to removal of silicone tube

p-value for Mann-Whitney test.

Table 3.
Success rates and incidence of granuloma according to acute conjunctivis
  Acute conjunctivitis p-value
(+) (n = 21) (−) (n = 526)
Success rates (% [eye]) 80.95 (17/21) 88.97 (468/526) 0.282*
Granuloma (% [eye]) 76.2 (16/21) 16.9 (89/526) <0.001*

* p-value for Mann-Whitney test.

Table 4.
Relation between timing of silicone tube removal and outcome of DCR
  Silicone tube removal (mean ± SD, mon)* p-value
Success (n = 17) 0.22 ± 0.28 0.047
Failure (n = 4) 1.13 ± 0.75

* Period from onset of acute conjunctivitis to removal of silicone tube

p-value for Mann-Whitney test.

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