Canalicular and nasolacrimal duct blockage: an ocular side effect associated with the antineoplastic drug S-1

Am J Ophthalmol. 2005 Aug;140(2):325-7. doi: 10.1016/j.ajo.2005.01.052.

Abstract

Purpose: To report canalicular stenosis as a side effect of the new antineoplastic agent S-1.

Design: Interventional case series.

Methods: Three patients who received S-1 for treatment of gastrointestinal cancer at a tertiary cancer center were evaluated and treated for epiphora.

Results: Two patients were found to have severe canalicular stenosis and nasolacrimal duct blockage after approximately 6 months of S-1 therapy. One patient underwent dacryocystorhinostomy with silicone tube placement on one side and dacryocystorhinostomy and Pyrex glass tube placement on the other side. The other patient declined a surgical intervention. One additional patient with epiphora had punctal stenosis early in the course of S-1 therapy. His epiphora resolved after probing and irrigation and 4 weeks of topical corticosteroid therapy.

Conclusions: Canalicular and nasolacrimal duct blockage is a previously unreported side effect of S-1 and should be recognized and treated at its earliest possible stage so that complete closure of the canaliculi can be avoided.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antimetabolites, Antineoplastic / adverse effects*
  • Dacryocystorhinostomy
  • Drug Combinations
  • Female
  • Gastrointestinal Neoplasms / drug therapy
  • Humans
  • Intubation
  • Lacrimal Duct Obstruction / chemically induced*
  • Lacrimal Duct Obstruction / therapy
  • Male
  • Middle Aged
  • Nasolacrimal Duct / drug effects*
  • Oxonic Acid / adverse effects*
  • Pyridines / adverse effects*
  • Tegafur / adverse effects*
  • Therapeutic Irrigation

Substances

  • Antimetabolites, Antineoplastic
  • Drug Combinations
  • Pyridines
  • S 1 (combination)
  • Tegafur
  • Oxonic Acid