[Diagnosis and therapy of chronic canaliculitis]

The chronic lacrimal canaliculitis is often overlooked and unsatisfactory treated. The purpose of this long-term study (1978-1991) is to call attention to special bacteriological signs and to give recommendations for proper treatment. 54 patients (39 females and 15 males) in age from 29 to 85 years (average age of 60 years) with a chronic lacrimal canaliculitis were evaluated. "Sulfur granules" were obtained from 32 patients and 54 specimens were collected from 44 patients and processed immediately for aerobic and anaerobic cultivation as well as microscopic investigation. Altogether 100 bacteria could be isolated: 56 anaerobes, 38 aerobes as well as 6 microaerophilic and capnophilic strains, respectively. Members of the genus Actinomyces were the most often isolated anaerobes. They could be detected in specimens of 15 patients by culture and in materials of 4 patients only by microscopic study. 42 from 50 patients were permanently cured by immediate treatment according to our operative procedure despite the splitted canaliculus. The most common cause of chronic lacrimal canaliculitis is a mixed infection. Despite the characteristic clinical symptoms the laboratory evaluation should be done to provide the diagnosis. The surgical procedure leads to a permanent functional healing in a high degree.