已知几种化学治疗剂可引起泪道引流狭窄和阻塞,导致顿花。培美曲塞就是这样一种药物,用于间皮瘤和非小细胞肺癌的治疗。培美曲塞在多个水平上抑制叶酸代谢。本病例是培美曲塞诱导的泪点和泪小管狭窄的第二例报告,但第一个记录泪镜检查结果并报告球囊点状泪管成形术作为一种微创治疗选择。
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.