Functional and anatomical outcomes of punctoplasty with Kelly punch

Vahdani, Kaveh; Sian, Indy; Giasin, Osama; Makrygiannis, Georgios

doi:10.1038/eye.2017.105

Cited by 5 publications

(2 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Currently there are no standardised clinical guidelines for the treatment of epiphora caused by punctal stenosis, and therapeutic approaches vary among oculoplastic surgeons. Common treatment modalities include the one-, 2-or 3-snip punctoplasty, simple punctal dilation followed by stent intubation, and Kelly punch-assisted punctoplasty with or without stenting [5,7,8,10,11]. Despite the numerous studies on these approaches, there is still no consensus on the most effective technique for the long-term successful treatment of symptomatic punctal stenosis.…”

Section: Discussionmentioning

confidence: 99%

Kelly punch punctoplasty vs. simple punctal dilation, both with mini-monoka silicone stent intubation, for punctal stenosis related epiphora

Goldberg

Priel

Zloto

et al. 2020

Eye

View full text Add to dashboard Cite

Objectives To compare the outcomes of stenotic punctal dilation by means of a punctal dilator alone vs. a Kelly punch punctoplasty, both followed by insertion of a mini-monoka stent, for treatment of symptomatic punctal stenosis. Methods A retrospective, comparative study. The participants were patients with punctal stenosis related epiphora treated at the Goldschleger Eye Institute, Sheba Medical Center. All patients were treated either by simple punctal dilation (group 1) or Kelly punch-assisted punctoplasty (group 2), both followed by mini-monoka stent insertion. Symptoms relief and subjective epiphora scoring (Munk score) were compared and analysed. Results Fifty patients were included in the study; Mean age (+SD) of the participants was 60 years (±12, range 30-86 years). Baseline characteristics (age, gender distribution, and visual acuity) were similar in both groups. The mini-monoka stent was placed for an average period of 2 weeks, and all patients received postoperative steroids and antibiotic treatment for 1 week. The Munk score decreased significantly in both groups following the procedure, dropping from 4.9 to 1.9 in group 1 and from 4.3 to 1.2 in group 2 (P < 0.005 for both groups). There was no difference in the delta Munk score between the two groups. Conclusions Simple punctal dilation followed by insertion of a mini-monoka stent is effective in alleviating the symptoms of punctal stenosis-related epiphora. There was no added benefit when the more invasive Kelly punch-assisted punctoplasty was used, raising some doubt about its justification in these cases.

show abstract

Section: Discussionmentioning

confidence: 99%

Kelly punch punctoplasty vs. simple punctal dilation, both with mini-monoka silicone stent intubation, for punctal stenosis related epiphora

Goldberg

Priel

Zloto

et al. 2020

Eye

View full text Add to dashboard Cite

show abstract

“…Punctoplasty of any kind should maintain the normal anatomy and physiology of the canalicular system to preserve the normal function of the lacrimal system. 18,21 It was hypothesized that Horner–Duverney’s muscle, which is part of the orbicularis muscle, plays a major role in the closure of the eyelids and the sphincter of the punctum. 22 Moreover, it probably has a role in the positioning of the punctum and in the pumping mechanism of the tears flowing into the lacrimal sac through the canaliculis.…”

Section: Discussionmentioning

confidence: 99%

Kelly Punch Punctoplasty and Simple Punctal Dilatation Are Equally Effective for Punctal Stenosis: A Prospective Study

Zloto¹,

Weissman²,

Moroz³

et al. 2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Purpose: To examine the clinical, imaging, and histopathologic differences between Kelly punch punctoplasty and punctal dilatation, both with mini Monoka stent insertion. Methods: This is a prospective, comparative clinical study. Patients with bilateral punctal stenosis and for whom surgery was advised participated in the study. The right eye underwent Kelly punch punctoplasty and the left eye simple punctal dilatation, both with mini Monoka stents were participated. Data were collected and analyzed before and 3 months following the procedure and included the degree of epiphora (Munk score) and punctal size as measured by anterior segment optical coherence tomography (AC- OCT). All specimens removed by the Kelly punch punctoplasty were sent for histopathologic evaluation, including Masson’s trichome muscle staining. Results: The study included 46 eyes of 23 patients (4 males and 19 females) whose mean age at presentation was 60.43 ± 14.81 years (range 19–84 years). There was a significant decrease in the Munk score after both punctoplasties compared with baseline values (P < 0.01, matched pairs). There were no significant differences between groups in the delta Munk score. There was a significant increase in punctal size after both procedures compared with baseline values as measured by AS-OCT. Horner–Duverney’s muscle was visible in only 3 of the 23 (13.04%) specimens from patients who underwent the Kelly punch punctoplasty. Conclusions: The Kelly punch punctoplasty and the simple dilator punctoplasty, both with stents, are equally effective treatments for epiphora due to acquired punctal stenosis. Only a few specimens removed during the Kelly punch method show muscle fibers.

show abstract

A major review on punctal stenosis: Part II: Updated therapeutic interventions, complications, and outcomes

Tawfik,

Ali

2024

Survey of Ophthalmology

View full text Add to dashboard Cite

Functional and anatomical outcomes of punctoplasty with Kelly punch

Cited by 5 publications

References 1 publication

Kelly punch punctoplasty vs. simple punctal dilation, both with mini-monoka silicone stent intubation, for punctal stenosis related epiphora

Kelly punch punctoplasty vs. simple punctal dilation, both with mini-monoka silicone stent intubation, for punctal stenosis related epiphora

Kelly Punch Punctoplasty and Simple Punctal Dilatation Are Equally Effective for Punctal Stenosis: A Prospective Study

A major review on punctal stenosis: Part II: Updated therapeutic interventions, complications, and outcomes

Contact Info

Product

Resources

About