Journal List > J Korean Ophthalmol Soc > v.51(6) > 1008846

Park, Ha, and Lew: Two Cases of Lacrimal Drainage Obstruction Associated With S-1 Anticancer Treatment



To report two cases of lacrimal drainage obstruction associated with the anticancer drug S-1 (tegafur, gimeracil, oteracil; TS-1®, Taiho Pharmaceutical, Japan).

Case summary

(Case 1) A 34-year-old male who had previously undergone a total gastrectomy for treatment of gastric cancer visited with epiphora in both eyes that had developed 6 months after S-1 treatment. On examination, a right canalicular obstruction and left punctal and nasolacrimal partial obstruction were noted. Endoscopic dacrycystorhinostomy with lacrimal trephinization was done in the right eye and punc-toplasty with punctal membrane removal and silicone tube intubation were performed in the left eye and the epiphora were successfully treated. (Case 2) A 60-year-old male who was treated with S-1 for gastric cancer presented with tearing in both eyes that had developed 2 months after S-1 treatment. Ophthalmic examinations revealed a right nasolacrimal partial obstruction in the right eye and lacrimal sac obstruction in the left. Silicone intubations were performed on both sides and the epiphora were successfully treated.


Lacrimal drainage obstructions may develop after S-1 treatment. Therefore, ophthalmologic evaluations should be performed in patients treated with S-1 to detect lacrimal drainage obstruction.


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Figure 1.
Preoperative photographs of case 1 patient show left (A) upper and (B) lower punctal stenosis.
Figure 2.
Preoperative macro digital subtraction dacryocystographic findings of case 1 patient show (A) right canalicular obstruction and (B) left nasolacrimal duct partial obstruction.
Figure 3.
(A) Histopathologic findings of punctal membrane (case 1) show subepithelial fibrosis (white arrow) be-low stratified squamous epithelium (black arrow) (hematoxylin-eosin, ×200) (B) Histopathologic findings of lacrimal sac (case 1) show chronic inflammation consisting of lymphocytes (black arrow) with fibrosis (white arrow) (hematoxylin-eosin, ×200).
Figure 4.
Preoperative macro digital subtraction dacryocystographic findings of case 2 patient show (A) right nasolacrimal duct partial obstruction and (B) left lacrimal sac obstruction.
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