Simple surgical punctal occlusion with high frequency radiowave electrosurgery

Abstract

Background To introduce and evaluate the efficacy of a simple punctal occlusion technique for dry eye patients. Methods Medical records of 79 eyes from 40 patients refractory to common dry eye conservative treatment who underwent multiple high-frequency radio-wave electro-punctal occlusion were retrospectively reviewed. Pre- and post-procedural ocular surface indices (Schirmer test, tear break-up time (TBUT), and corneal staining grade (Oxford scheme)) and subjective symptom scores (including frequency of artificial tear use, interval between procedures, and total repeat time) were analyzed. Results Average Schirmer test result was significantly (P < 0.05) improved from 4.10 ± 1.39 mm to 8.14 ± 3.13 mm at 6 weeks after the procedure (n = 79). A total of 32 eyes from 16 patients underwent repeated procedure with a mean interval of 8.00 ± 4.86 months, while 24 patients had a single procedure. Twenty-five of 30 patients showed improvement for subjective symptom scores. No complications related to the procedure were observed. Conclusions A simple, less-invasive punctal occlusion technique using a fine-needle tip with high-frequency radio-wave could significantly relieve subjective symptoms and improve ocular surface indices of patients with aqueous deficient dry eye without causing a major complication. This procedure may play a considerable role in treating dry eye refractory to common practices.

Evaluation of the Effect of Plasma Occlusion of Punctum (POP) on Dry Eye Disease Treatment: A 6-month Randomized Clinical Trial

“…The conventional methods for punctal occlusion are thermal Cauterization, Radiofrequency Electrosurgery, Combined Canalicular Cauterization and Punctal Suturing, Punctal Plugs and Punctal Occlusion with Amniotic Membrane [8,[23][24][25][26]. In all fields of medicine, the preferred initial treatment option is typically the least invasive approach.…”

“…They claimed that, in spite of effective reported results in these articles for punctal plugs, they unmask the inconclusiveness of this DED treatment [8]. Woo Park et al reported that high-frequency radio-wave electro-punctal occlusion on 79 eyes at Samsung Hospital is a promising treatment for aqueous-deficient dry eye disease (DED) [23].…”

Intense pulsed-light treatment improves objective optical quality in patients with meibomian gland dysfunction

“…The participants were asked to open their eyes wide and look straight, and a single ophthalmologist (KK) measured the time taken for a black spot or line to appear on the cornea. Interval between last blink to the first sign of tear film rupture was recorded as TBUT [ 45 , 46 ]. While measuring TBUT, the CFS score (0–9) was also evaluated [ 47 ].…”