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Abstract ID: 24-121
Outcomes of surgical procedures for canalicular obstruction caused by the anticancer drug S-1
Tsugihisa Sasaki
Purpose
To evaluate the outcomes of different surgical interventions for canalicular obstruction caused by oral administration of S-1, a 5-FU analogue used as anticancer therapy.
Methods
A total of 48 patients (31 males, 17 females; 68.1 ± 10.5 years old, mean ± SD) had S-1–related canalicular obstruction on 91 sides. Patients had visited our clinic between 2007 and 2022 and were followed up for at least one year postoperatively or one year after removal of the silicone tube. We classified the patients into five groups based on the type and location of obstruction: Group A (punctal obstruction/stenosis), Group B (horizontal canalicular obstruction [CO] with contralateral membranous CO or stenosis [CS]), Group C (upper and lower membranous CO), Group D (upper and lower tight CO), and Group E (common canalicular obstruction and punctal stenosis). We performed various surgical procedures, as follows, depending on the group and the severity of obstruction.
Results
In Group A, the 3-snip procedure was successful on 32/34 sides (94.1%). In Group B, probing plus monocanalicular tube insertion was successful on 1/4 sides (25.0%). In contrast, probing plus bicanalicular tube insertion was successful on 2/3 sides (66.7%). In Group C, marsupialization plus bicanalicular tube insertion was successful on 2/4 sides (50%), while probing plus bicanalicular tube insertion was successful in 3/9 sides (33.3%). In Group D, 4 cases underwent marsupialization and 3 underwent probing plus bicanalicular tube insertion, all of which resulted in failure. Conversely, conjunctivodacryocystorhinostomy (CDCR, Jones tube implantation) succeeded in most cases 16/20 (80.0%) in Group D, and fair results were observed in 3 cases (15.0%). The 3-snip procedure and dacryoendoscopic canaliculoplasty were used for all four patients (100%) in Group E, and all were successful.
Conclusion
Acceptable results were observed with the 3-snip procedure in cases of punctal obstruction and CDCR in cases of CO in patients with S-1–associated lacrimal obstruction.
Additional Authors
Chika Miyazaki – Sasaki Eye Clinic
Miou Hirose – Sasaki Eye Clinic
Maki Hayami – Sasaki Eye Clinic