A novel surgical technique for punctal stenosis: placement of three interrupted sutures after rectangular three-snip punctoplasty

Abstract

BackgroundWe developed a novel surgical technique to treat punctal stenosis involving the placement of three interrupted sutures after rectangular three-snip punctoplasty (TSP).MethodsRetrospective chart review of forty-eight eyes of 44 patients who underwent rectangular TSP with three interrupted sutures was performed. We investigated whether anatomical recurrences (re-stenosis) occurred during the follow-up period. The subjective symptoms of patients were surveyed.ResultsThe mean patient age was 64.1 years, and the mean follow-up time was 17.4 months. The placement of three interrupted sutures after rectangular TSP afforded satisfactory outcomes. Regarding subjective symptoms, 91.7% of the eyes (44/48) were reported as improved. Among 4 eyes determined as symptomatic failure, anatomical recurrence (re-stenosis of the punctum) was observed in only one eye. The other three (6.25%, 3/48 eyes) showed functional nasolacrimal obstruction, namely epiphora with patent tear duct.ConclusionsPlacement of three interrupted sutures after rectangular TSP to treat punctal stenosis showed promising results. Notably anatomical success rate was about 98%. Further comparisons between the novel surgical technique and conventional techniques are required.

Akkiz punktum stenozunda tanı, etyoloji ve tedavi seçenekleri

“…Park ve ark. [38] bu yöntemle anatomik restenozu sadece %2,1 olarak kaydetmişlerdir. 4-SP'de ise dört insizyon ile posteriordan kanalikül proksimalinin de dahil olduğu geniş bir eksizyon yapılır [39].…”

Anatomical and Functional Outcome of Rectangular Three Snip Punctoplasty in Primary Acquired Punctal Stenosis in a Tertiary Care Hospital of Karachi

“…A third vertical or horizontal cut is given after which the base of the flap is removed. 10,11 Various surgical techniques and adjunct therapies have thereby, been undertaken in a hope to improve surgical outcome. Adjunct therapies like use of mitomycin C, Kelly's and Reiss punctal punch, stents, punctal plugs, pigtail probe and placement of interrupted sutures after punctoplasty have been employed to aid management of complicated cases of punctal stenosis.…”

Rectangular 3-snip punctoplasty versus punch punctoplasty with silicone intubation for acquired external punctal stenosis: a prospective randomized comparative study

“…Until now, there has been no acceptable guidelines for the management of AEPS. Attempts to resolve the stenosis has been reported as a 1-snip, 2-snip, 3-snip or 4-snip procedure, punctal dilatation (with or without mitomycin-C), perforated punctal plugs, Mini-Monoka, and self-retaining bicanalicular stents [2][3][4][5][6][7][8][9][10] . However, how to reduce the surgical injury and improve the success rate of operation remains controversial.…”