Fungus at Removed Silicone Tubes in Nasolacrimal Duct Obstruction Patients

Shin, Hyun Min; Lew, Helen; Yun, Young Su

Abstract

PURPOSE
This study investigated the fungi of silicone tubes in the patients with nasolacrimal duct obstruction, and investigated the identification of fungi according to operation type, clinical features and detailed locations of silicone tubes. METHODS: The subjects of this study were 49 eyes of 40 patients operated on for nasolacrimal duct obstruction from July 2003 to April 2004. The removed silicone tubes were divided into the parts of conjunctiva, lacrimal drainage system and nasal cavity according to insertion state, after which fungus culture was performed using them. We classified patients into the silicone tube intubation group and the dacryocystorhinostomy group. Preoperative nasal problems, dacryolith on dacryocystorhinostomy, postoperative features of nasal cavity during the follow-up period and success of operation were retrospectively investigated with the medical records. Correlations of the results of fungus culture and clinical features were verified by Pearson Chi-Square test. RESULTS: Fungus culture rate was significantly higher in the dacryocystorhinostomy group (37.5%) than in the silicone tube intubation group (12.12%) (p-value<0.05). In total patients according to insertion site, fungus culture rate was significantly higher in the nasal cavity than in the lacrimal drainage system, and in the lacrimal drainage system than in the conjunctiva (p-value<0.05). The species of cultured fungi were in the following order: Candida, Trichosporon, Penicillium and Aspergillus. CONCLUSIONS: Fungal infection of the silicone tube in patients with nasolacrimal duct obstruction was found and fungi species were cultured. Further study is needed of fungi in the nasolacrimal duct before surgery for determining the fungal infection causing nasolacrimal duct obstruction.