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At least 811 records · Page 45Linked to original sources
PubMed2005

Is routine biopsy of the lacrimal sac wall indicated at dacryocystorhinostomy? A prospective study and literature review.

OBJECTIVE: To determine whether routine biopsy of the lacrimal sac wall at dacryocystorhinostomy (DCR) is indicated. METHODS: A prospective study and literature review. In 193 consecutive endoscopic DCRs performed on 164 patients (108 females and 56 males) part of the medial wall of the lacrimal sac was sent for histological examination. The mean age of the patients was 64 years with a range of 2.5-89 years. Previous reported series were reviewed. RESULTS: Of the 193 specimens, 44 (23%) showed normal histology, 146 (76%) showed varying degrees of non-specific chronic inflammation, and three (1.2%) showed specific pathology. Of the three specimens that showed specific pathology two showed sarcoidosis and one showed transitional cell papilloma. The two specimens with sarcoidosis were obtained from one patient who underwent bilateral surgery. In this and the six previous reported series only seven of 1294 specimens (0.5%) showed specific pathology, which was definitely not suspected preoperatively or intraoperatively, and only one of these (0.08%) was found to be malignant (a lymphoma). CONCLUSIONS: Biopsy of the lacrimal sac wall at DCR is not indicated routinely and is only indicated if there is a reason to suspect pathology other than chronic inflammation preoperatively or intraoperatively.

Adolescent↗
PubMed1978

Canaliculitis with isolation of Pityrosporum pachydermatis.

A case of canaliculitis with obstruction of the lacrimal canaliculus and accumulation of conglomerates is described. Pityrosporum pachydermatis was cultured from the conglomerates. To the best of our knowledge this organism has not been previously implicated in such infections. Cure was obtained by treatment with nystatin administered topically and as an irrigation of the lacrimal pathways. The possibility that the pathogenesis of the canaliculitis and obstruction of the lacrimal pathways lies in decreased function of the lacrimal pump is discussed.

Dacryocystitis↗
PubMed1984

Canaliculitis caused by Enterobacter cloacae: report of a case.

A 65-year-old man developed canaliculitis first of the left lower and later of the left upper lacrimal canaliculus. Mucoid material expressed from the upper canaliculus grew a pure culture of Enterobacter cloacae, the colonies of which had a stringy, tenacious, mucoid property consistent with the clinical findings. Treatment with topical chloramphenicol and oral ampicillin was followed by complete resolution.

Aged↗
PubMed1984

Senile atrophy of the human lacrimal gland: the contribution of chronic inflammatory disease.

Histological examination of 99 human lacrimal glands showed a relationship between atrophy of the secretory acini and secretory duct obstruction, ascending periductal fibrosis, and obliteration of the adjacent blood vessels caused by lymphocytic and polymorphonuclear inflammation. Investigation of the subgroups of the B lymphocytic series by immunohistochemistry did not show any statistical change with age, sex, fibrosis, or lymphocytic inflammation. The concept of senile atrophy occurring as a result of senescent involution of the lacrimal gland is challenged on the basis of the histological findings.

Adolescent↗
PubMed1989

The EEC syndrome and its ocular manifestations.

The EEC syndrome (ectrodactyly or lobster-claw deformity, ectodermal dysplasia, and cleft lip and palate) is a rare disorder with autosomal dominant inheritance, variable expression, and in some families lack of penetrance. We present the findings in five cases with emphasis on the ocular findings. Lacrimal surgery was performed on three patients with good results in each case. We also report the occurrence of spontaneous corneal perforation in two cases, a complication not previously recognised. The ophthalmic care of these patients must be pursued long-term, as progressive visual impairment may be the most disabling feature of the syndrome.

Abnormalities, Multiple↗
PubMed2003

Late and very late initial probing for congenital nasolacrimal duct obstruction: what is the cause of failure?

AIMS: To find the cure rate of late (second year of age) and very late (3-5 years of age) initial probing for congenital nasolacrimal duct obstruction (CNLDO) and to identify the factors contributing to the failure rate of the probing in older children. METHODS: In a prospective interventional case series study, 169 eyes of 125 consecutive patients (1-5 years old) with CNLDO underwent probing under general anaesthesia. Cure was defined as absence of tearing and discharge in the affected eye. RESULTS: 138 eyes of 101 patients aged 13-60 months (mean 23.4 (SD 10.2)) were included. Of 15 eyes (10.8%) with complex CNLDO, 80% presented after 24 months of age (p<0.0001). The cure rate was 89% in patients 13-24 months of age and 72% after the age of 24 months (p = 0.01). It was 90.2% in the membranous and 33.3% in the complex CNLDO in both late and very late probing (p<0.0001). There was a high correlation (r = 0.97) and no significant difference between the cure rate at 1 week and final follow up. CONCLUSION: Accumulation of the complex CNLDO is the main risk factor for failure of probing in the older children. The outcome of the nasolacrimal duct probing at 1 week follow up is highly indicative of the final outcome.

Age Factors↗
PubMed1995

Chronic dacryosialadenitis in HTLV I associated myelopathy.

A prospective study was carried out on 48 patients with HTLV I associated myelopathy/tropical spastic paraparesis (HAM/TSP) to assess the association between this entity and Sjögren's syndrome. Fourteen patients (29.1%) had chronic dacryosialadenitis confirmed by a positive Schirmer's test and salivary gland biopsy. None of these patients had evidence of collagen disease and tests for Ro, La, and rheumatoid factor were negative except in one case. Therefore, the dacryosialadenitis could not be classified as either primary or secondary Sjögren's syndrome. Ten of the 14 patients (71.4%) had other systems (haematological, articular, dermatological, or respiratory) involved apart from the neurological and exocrine gland pathology. The findings suggest that the dacryosialadenitis associated with HTLV I is a disease of viral origin distinct from Sjögren's syndrome.

Adult↗
PubMed1979

Computed tomography of masses in the lacrimal gland region.

Twenty patients with mass lesions in the lacrimal gland region were evaluated with computed tomography (CT). The extent of the mass and its relationship to the globe, optic nerve, and extraocular muscles were clearly seen. The CT appearance on plain scan and the presence or absence of contrast enhancement, bone involvement, and cystic components often suggested the specific pathological diagnosis. Although orbital ultrasonography and CT were frequently complementary, ultrasonography was more definitive in inflammatory diseases, while CT demonstrated better extraorbital extension.

Adenocarcinoma↗
PubMed1990

Evaluation of the lacrimal apparatus with digital subtraction macrodacryocystography.

Patients who suffer from epiphora can benefit from reconstructive surgery in many cases of obstructive and nonobstructive lesions of the lacrimal apparatus. We describe our technique of digital subtraction macrodacryocystography (DSM) and discuss its efficacy in the evaluation of various abnormalities involving the lacrimal drainage pathway. A variety of pathologic conditions of the lacrimal apparatus are portrayed. DSM is an accurate, easy to perform, but relatively unrecognized method of anatomic localization of obstructive lesions within the lacrimal drainage system.

Dacryocystitis↗
PubMed1996

Nonsurgical placement of a nasolacrimal polyurethane stent: long-term effectiveness.

PURPOSE: To evaluate the long-term effectiveness of a polyurethane stent in the treatment of obstruction of the lacrimal sac and the nasolacrimal duct. MATERIALS AND METHODS: Fluoroscopically guided placement of a polyurethane nasolacrimal stent was evaluated in 283 obstructed lacrimal systems of 236 patients, with a follow-up period of more than 1 year (range, 52-134 weeks). The obstruction was at the junction between the lacrimal sac and the nasolacrimal duct in 192 systems, at the lacrimal sac in 52, and at the nasolacrimal duct in 39. The causes of obstruction were traumatic in 34 and idiopathic in 249 systems. RESULTS: Stent placement was technically successful in 270 systems (95%). At 7 days after stent placement, 235 (87%) of the 270 systems with successful placement demonstrated complete resolution of epiphora, 27 (10%) had partial resolution, and the remaining eight (3%) had no resolution. There was recurrence in 81 systems due to obstruction of the stent (n = 77) or obstruction of the common canaliculus (n = 4). The recurrence rate was much higher in the systems with obstruction at the lacrimal sac (64%) than in the systems with obstruction at the junction (26%) between the lacrimal sac and nasolacrimal duct or at the nasolacrimal duct (15%). CONCLUSION: Stent placement in the obstructed lacrimal system below the junction between the lacrimal sac and the nasolacrimal duct is valuable as an initial therapy.

Adolescent↗
PubMed1996

Role of the ICAM-1/LFA-1 pathway during the development of autoimmune dacryoadenitis in an animal model for Sjögren's syndrome.

We have analyzed the role of cell adhesion molecules during the development of autoimmune dacryodenitis in an NFS/sld mouse model for primary Sjögren's syndrome. The expression of cell adhesion molecules was assessed by RT-PCR and immunohistochemistry. We detected an up-regulation of local cell adhesion molecule genes (ICAM-1, LFA-1, CD44 and Mel-14) in the course of autoimmune lacrimal gland diseases. Immunohistochemically, ICAM-1 was localized exclusively in the endothelial cells of variously sized blood vessels before the onset of disease, and LFA-1, CD44 and Mel-14, expressing infiltrating cells, were found within these lesions. When the therapeutic effects of blocking cell adhesion molecules in vivo were examined, antibodies to ICAM-1 in combination with anti-LFA-1 prevented the development of autoimmune lacrimal gland diseases in NFS/sld mice. These data suggest that in Sjögren's syndrome-like autoimmune dacryoadenitis in NFS/sld mutant mice, the ICAM-1/LFA-1 pathway may play a crucial role in the development and subsequent progression of T-cell-mediated autoimmunity in the lacrimal glands.

Animals↗