J Korean Ophthalmol Soc.  2014 Oct;55(10):1418-1425. 10.3341/jkos.2014.55.10.1418.

The Effectiveness of Topical Steroid Instillation in Patients with Recently Developed Nasolacrimal Drainage Stenosis

• Kim YD
• Kim NJ
• Choung HK
• Khwarg SI

• KMID: 2216858
• DOI: http://doi.org/10.3341/jkos.2014.55.10.1418

Abstract

PURPOSE
To evaluate the effectiveness of topical steroid instillation and associated factors in patients with recently developed nasolacrimal drainage stenosis.
METHODS
The medical records of 108 eyes of 56 patients who received topical steroid for nasolacrimal drainage stenosis between January 2010 and June 2013 and who developed epiphora of a three-month duration were retrospectively reviewed. Evaluations were performed at 1, 3, and 6 months after instillation of topical steroid. Subjective symptoms, tear meniscus height, and fluorescein dye disappearance test results were noted at every follow-up visit; nasolacrimal irrigation and canalicular probing were also performed as needed.
RESULTS
The cumulative improvements were 42.0% at 1 month and 51.0% at 3 months after treatment, and the mean period of symptomatic improvement was 3.8 +/- 1.9 weeks (range, 3-12 weeks). At the final follow-up visit, 56 (51.9%) of 108 eyes showed improved epiphora. Final improvement was observed in 63% (12 of 19 eyes) of idiopathic nasolacrimal drainage stenosis patients, in 100% (10 of 10 eyes) of docetaxel-treated patients, and in 43% (34 of 79 eyes) of S-1-treated patients.
CONCLUSIONS
Instillation of topical steroids can be effective for nasolacrimal drainage stenosis and may prevent the need for invasive surgical treatment.

Keyword

Docetaxel; Epiphora; Nasolacrimal drainage stenosis; S-1; Topical steroid

MeSH Terms

Constriction, Pathologic*
Drainage*
Fluorescein
Follow-Up Studies
Humans
Lacrimal Apparatus Diseases
Medical Records
Retrospective Studies
Steroids
Fluorescein
Steroids

Figure

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  Figure 1. The cumulative incidence of epiphora improvement after treatment of topical steroid.

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  Figure 2. The cumulative incidence of epiphora improvement after treatment of topical steroid, grouped by the etiology of nasolacrimal drainage stenosis. Differences of cumulative incidence of improvement between subgroups were not significant (p = 0.305, log rank test).

Reference

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