Japanese journal of ophthalmology · 2026
Surgical procedures and outcomes in patients with tear drainage system disorders associated with the anticancer agent S-1.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Sasaki Tsugihisa, Sounou Tsutomu, Higashide Tomomi
Аннотация
PURPOSE: S-1 is a first-line oral anti-cancer drug widely used in Japan. This study evaluated surgical outcomes for S-1-associated tear drainage system disorders (S-1/TDSD) and explored strategies to improve outcomes.
STUDY DESIGN: Multicenter, retrospective observational study.
METHODS: Fifty-one patients (89 sides; 31 men and 20 women; mean age ± SD, 68.7 ± 10.7 years; range 49─85 years) with S-1/TDSD were included. Surgical procedures performed were: three-snip procedure; exploratory horizontal part canaliculotomy; probing with tube placement; and conjunctivodacryocystorhinostomy with Jones tube insertion.
RESULTS: The cases were classified as: punctal occlusion (Group a, 34 sides), both stenosed canaliculi (Group b, 2 sides), patent canaliculus and mono-canalicular obstruction (CO) (Group c, 9 sides), one soft or tightCO and contralateral softCO (Group d, 13 sides), tightCOs in both canaliculi (Group e, 27 sides), and common CO (Group f, 4 sides). The three-snip procedure for Group a was successful in 32 of 34 sides (94.1%). Probing with intubation for Group b was successful in all cases (2/2). Conjunctivodacryocystorhinostomy for Group e was successful in 15 of 20 sides (75.0%) and dacryoendoscopic canaliculo-incision for Group e was successful in 4 of 4 sides (100%). However, exploratory horizontal part canaliculotomy and probing for Groups c and d were successful in 14%─42% of cases.
CONCLUSION: The three-snip procedure for punctal occlusions showed favorable outcomes but procedures preserving the canaliculus, especially in patients with horizontal CO, did not yield good results, even for an affected single canaliculus.
STUDY DESIGN: Multicenter, retrospective observational study.
METHODS: Fifty-one patients (89 sides; 31 men and 20 women; mean age ± SD, 68.7 ± 10.7 years; range 49─85 years) with S-1/TDSD were included. Surgical procedures performed were: three-snip procedure; exploratory horizontal part canaliculotomy; probing with tube placement; and conjunctivodacryocystorhinostomy with Jones tube insertion.
RESULTS: The cases were classified as: punctal occlusion (Group a, 34 sides), both stenosed canaliculi (Group b, 2 sides), patent canaliculus and mono-canalicular obstruction (CO) (Group c, 9 sides), one soft or tightCO and contralateral softCO (Group d, 13 sides), tightCOs in both canaliculi (Group e, 27 sides), and common CO (Group f, 4 sides). The three-snip procedure for Group a was successful in 32 of 34 sides (94.1%). Probing with intubation for Group b was successful in all cases (2/2). Conjunctivodacryocystorhinostomy for Group e was successful in 15 of 20 sides (75.0%) and dacryoendoscopic canaliculo-incision for Group e was successful in 4 of 4 sides (100%). However, exploratory horizontal part canaliculotomy and probing for Groups c and d were successful in 14%─42% of cases.
CONCLUSION: The three-snip procedure for punctal occlusions showed favorable outcomes but procedures preserving the canaliculus, especially in patients with horizontal CO, did not yield good results, even for an affected single canaliculus.