A rare case of pemetrexed-induced diffuse punctal and canalicular stenosis: management by coronary balloon puncto-canaliculoplasty

ABSTRACT

Several chemotherapeutic agents are known to induce lacrimal drainage stenosis and obstruction, resulting in epiphora. Pemetrexed is one such drug and is used in the management of mesotheliomas and non-small cell lung carcinomas. Pemetrexed inhibits folate metabolism at multiple levels. The present case is the second report of pemetrexed induced punctal and canalicular stenosis, but the first to document dacryoendoscopy findings and report balloon puncto-canaliculoplasty as a minimally-invasive treatment option.

KEYWORDS:

• Balloon dacryoplasty
• canalicular stenosis
• chemotherapy
• epiphora
• lacrimal
• punctal stenosis
• puncto-canaliculoplasty

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Financial disclosure

Prof. Ali receives royalties from Springer for his texts ‘Principles & Practice of Lacrimal Surgeries’, ‘Atlas of Lacrimal Drainage Disorders’ and ‘Video Atlas of Lacrimal Drainage Surgeries’.

Additional information

Funding

The work was funded by Hyderabad Eye Research Foundation. The funder had no role in the design or conduct of the study.