International Journal of Medical Sciences

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18 October 2017

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Int J Med Sci 2016; 13(10):800-805. doi:10.7150/ijms.16515

Research Paper

Lacrimal Duct Occlusion Is Associated with Infectious Keratitis

Guigang Li1, Jingmin Guo1, Rong Liu1, Weikun Hu1, Lingjuan Xu1, Juan Wang1, Subo Cai1, Hong Zhang1, Yingting Zhu2✉

1. Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
2. TissueTech, Inc., Miami, FL, USA

Abstract

Background: To explore the prevalence of lacrimal duct obstruction in patients with infectious keratitis, and the necessity of lacrimal duct dredge in the treatment of human infectious keratitis.

Methodology/Principle Findings: The design is prospective, non-control case series. Thirty-one eyes from twenty-eight continuous patients with infectious keratitis were included in this study. The presence/absence of lacrimal duct obstruction was determined by the lacrimal duct irrigation test. The diagnosis of infectious keratitis was made based on clinical manifestations, cornea scraping microscopic examination and bacterial/fungus culture. Diagnosis of viral keratitis was set up based on the recurrent history, deep neovascularization and typical outlook of the cornea scar. The treatment of keratitis included drugs, eye drops or surgery, while treatment of chronic dacryocystitis was lacrimal duct dredging with supporting tube implantation surgery. In the thirty-one eyes with infectious keratitis, fifteen suffered from fungal keratitis (48%), two bacterial keratitis (6%), and fourteen viral keratitis (45%). Eleven eyes (35%) from ten patients with infectious keratitis also suffered from lacrimal duct obstruction. In those cases, six eyes also suffered from lower canalicular obstruction, three nasolacrimal duct obstruction and chronic dacryocystitis, one a combination of upper and lower canalicular obstruction, one upper canalicular obstruction. After local and systemic applications of anti-bacterial, anti-viral, anti-fungal and anti-inflammatory drugs, twenty-eight eyes (90%) recovered within three weeks, while the ulceration of three patients required the lacrimal duct dredging and supporting tube implantation surgery for the healing.

Conclusions: Herein, we first report that the prevalence of infectious keratitis is closely correlated to the occurrence of lacrimal duct obstruction. When both confirmed, simultaneous treatment of keratitis and lacrimal duct obstruction promptly is required. Further evaluation of mechanism, prevention and control of the diseases are warranted.

Keywords: Infectious Keratitis, Chronic Dacryocystitis, Lacrimal Duct Obstruction, Lacrimal Duct Dredging

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How to cite this article:
Li G, Guo J, Liu R, Hu W, Xu L, Wang J, Cai S, Zhang H, Zhu Y. Lacrimal Duct Occlusion Is Associated with Infectious Keratitis. Int J Med Sci 2016; 13(10):800-805. doi:10.7150/ijms.16515. Available from http://www.medsci.org/v13p0800.htm