Cautery Applications to Relieve Punctal Stenosis

Long-term Success Rate of Perforated Punctal Plugs in the Management of Acquired Punctal Stenosis

“…The reported success rates for the treatment of acquired punctual stenosis range between 76% and 96%, where better results were achieved in cases demonstrating normal probing and normal lower eyelid position. 2,[7][8][9][10][11][12] The goal of these procedures is to create a permanent channel through which tears can drain. The use of PPP for this purpose was first described by Bernard et al 13 based on a modification of the punctal plugs used for the treatment of dry eye syndrome.…”

“…10 Electrocautery and laser treatment, which are more frequently used to create punctual occlusion in dry eye syndrome, can be also used for punctal opening. 11,12 However, recurrent stenosis may be encountered after these procedures as a result of scar formation during wound healing. 9,10 In 1989, Bernard et al 13 described temporary punctal stenting with perforated punctal plugs (PPP) for the treatment of acquired punctal stenosis, and studies evaluating the success rates of PPP reported promising results.…”

Assessment and management of proximal and incomplete symptomatic obstruction of the lacrimal drainage system

“…Different methods of punctoplasty have been used to augment punctal size, including 1, 2, and 3-snip punctoplasty,55–58 punctum pucker procedure,51 posterior punctectomy with intraoperative mitomycin-C (MMC),47 one-snip punctoplasty, with mini Monoka tube insertion,52 microsurgical punctoplasty,53 punch (wedge) punctoplasty,24 laser punctoplasty, and electrocautery 49. Two-snip57 and three-snip58 punctoplasties have been advocated after failure of one-snip punctoplasty.…”

“…Fein49 reported early success in 28 of 35 eyes after cautery to treat AEPS, with recurrence of epiphora in nine cases of 24 eyes after a one-year follow-up. Kristan and Branch15 inserted a temporary punctal plug after a one-snip punctoplasty and achieved symptomatic improvement in all 25 AEPS.…”

The Watery Eye - Management and Results

“…The fibrotic type of stenosis is seen less frequently overall; whilst some patients have a history of ipsilateral Herpes Simplex infection and treatment, the majority do , not, although they often do have a histov of repeated dilatations, and an iatrogenic element may therefore be possible in some. Fein (1977) where the other canaliculus is occluded (except as a necessary adjunct to excision of a medial lid lesion). Absence of lacrimal puncta is associated with patent canaliculi in many patients (77% in the series of Putterman 1973).11…”