Three-snip punctoplasty versus perforated plugs for management of lacrimal punctal stenosis

Tamer, Salma S; Abdelghany, Ahmed A.; Elshafei, Ahmed; Abdallah, Raafat Mohyeldeen Abdelrahman

doi:10.1177/1120672120925035

Cited by 10 publications

(7 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We did a correlation between the previous causes and age; we noted that multiple causes of punctual occlusion related to aging. In addition, the results of Tamer et al [17] revealed that 46 eyes (57.5%) had Grade 1 punctal stenosis, and 34 eyes (42.5%) had Grade 2. Twenty-four eyes (30%) had epiphora Grade 3 and 56 eyes (70%) had epiphora Grade 4.…”

Section: Discussionmentioning

confidence: 95%

Prevalence and Determinants of Punctal Occlusion at Ophthalmology Outpatient Clinic at Tanta University Hospital

Mohamed

Awara²,

Eldsouky³

et al. 2022

JAMMR

View full text Add to dashboard Cite

Background: Along with canalicular or nasolacrimal duct blockage, punctum stenosis is one of the most common causes of epiphora. The purpose of the study was to investigate the prevalence of punctal occlusion outlining their presentation varieties and etiological factors. Methods: This cross-section observational study conducted on 50 patient suffering from epiphora. Patients were divided into two groups: single cause(N=19) and combination of causes (N=31). Every patient underwent: taking of the history, examination (examination of the eyelids, lid closure and lagophthalmos), evaluation of the punctum (by usage slit light for visibility, appearance and the occurrence of inflammation or oedema). Schirmer, I test used for ocular surface examination. Results: Occlusion was significantly higher in single cause than combination of causes while stenosis was significantly lower in single cause than combination of causes groups. Grades of stenosis were significantly different between the two groups. Schirmer test, lower tear meniscus height, and side of lesion were insignificantly different between study groups. Conclusions: Punctal stenosis was an extremely frequent finding in individuals suffering from epiphora. Age tended to augment the prevalence of punctal stenosis, and many patients accompanied by post-cataract surgery combined with blepharitis then topical anti-glaucoma eye drops with recurrent conjunctivitis were most common association with punctal stenosis patients who had combination of causes.

show abstract

Section: Discussionmentioning

confidence: 95%

Prevalence and Determinants of Punctal Occlusion at Ophthalmology Outpatient Clinic at Tanta University Hospital

Mohamed

Awara²,

Eldsouky³

et al. 2022

JAMMR

View full text Add to dashboard Cite

show abstract

“…Amongst the different punctoplasty procedures described in the literature, rectangular TSP has become popular due to its ability to prevent the disruption of the horizontal canaliculus required for the normal lacrimal pump mechanism, with a success rate that varies between 74.7% and 93.8%. 12,19–21 Chak and Irvine 12 reported 93.8% anatomical and 89.8% functional success rates at mean 8.2 months follow-up. However, Ali et al 19 reported that complete resolution of symptoms was achieved in 74.7% of eyes, although 94.3% anatomical success rate a minimum 6 months follow-up.…”

Section: Discussionmentioning

confidence: 95%

“…However, Ali et al 19 reported that complete resolution of symptoms was achieved in 74.7% of eyes, although 94.3% anatomical success rate a minimum 6 months follow-up. Tamer et al 20 demonstrated 90% surgical success, and Singh et al 21 reported 84% anatomical success rates at 6-month follow-up. In general, the variations in the success rates of rectangular TSP may be related to the difference in the follow-up period as the restenosis rate is more likely to increase over time.…”

Section: Discussionmentioning

confidence: 99%

The relationship between histopathological features and surgical success in primary acquired punctal stenosis

Eroglu

İnanç

Sabuncuoğlu

et al. 2021

European Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose: To investigate the pathophysiology of punctal stenosis based on histopathological features, and to assess the correlation between histopathological findings and treatment outcomes in primary punctal stenosis. Methods: A total of 43 eyes of 34 consecutive patients with primary punctal stenosis were included in this prospective study. Punctum specimens obtained by rectangular three-snip punctoplasty (TSP) were examined based on the multilayered structure of the epithelium and subepithelial histopathology. The correlation between the histopathological findings and treatment outcomes was evaluated. Results: A total of 61.8% of the patients were female and had an average age of 62.4 (41–81) years. Based on the histopathological examination, all 43 puncta consisted of non-keratinized stratified squamous epithelia. Subepithelial pathology demonstrated inflammation in 10 puncta (23.3%), fibrosis in 19 puncta (44.2%) and both inflammation and fibrosis in 11 puncta (25.6%). There was a moderate relationship between the presence of subepithelial fibrosis and symptom duration ( r = 0.4, p = 0.03). The surgical success was 88.4% at the mean of 12.4 ± 3.5 months follow-up. The surgical success was clinically lower in the puncta with exhibited fibrosis, although it was not statistically significant ( p = 0.6). Conclusion: Although the findings for almost all punctum specimens were consistent with fibrosis, inflammation or both, subepithelial fibrosis was detected as the most common histopathological feature. Clinically lower surgical success rates in puncta exhibiting fibrosis may be associated with a longer duration of symptoms and excessive postoperative healing response.

show abstract

“…Regarding position, no plug dislodgment or migration was found in this study. In the study of Abd El Ghafar et al [ 13 ] two plugs out of 30 (6.7%) had extruded before 6 months postoperatively versus one plug out of 45 plugs within 2 weeks in the study of Ozgur et al [ 14 ], and also one out of 40 during the 1st month in the study of Tamer et al [ 15 ], who reported additional rotation of four plugs (10%) via the slit lamp examination. The perforated plug was designed to have a shorter medial side compared with the lateral side so that its collar has a higher flange towards the temporal side of the lacrimal papillae and a lower one towards the medial side of the punctum in relation to the lacus lacrimalis to ensure better tear drainage.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of implanted perforated lacrimal punctal plugs using anterior segment optical coherence tomography

2021

Self Cite

View full text Add to dashboard Cite

Purpose Evaluation of the patency and position of perforated lacrimal punctal plugs implanted for treating punctal stenosis together with quantitative assessment of the precorneal tear film using anterior segment optical coherence tomography (AS-OCT). Methods In a prospective study, the lower punctum of 54 eyes of 29 patients implanted with perforated punctal plugs were examined using AS-OCT during the early postoperative period. Preoperative tear meniscus height (TMH) and tear meniscus area (TMA) were evaluated. Postoperatively, the patency of the plug, its position, TMH and TMA were evaluated, and the results were correlated with postoperative epiphora. Munk scale was used for epiphora grading. Results Using AS-OCT, 48 (88.9%) plugs were found in proper position while 6 (11.1%) were rotated. The lumen of the plugs was completely patent in 47 (87%) plugs, partially obstructed in 2 (3.7%) plugs and completely occluded in 5 (9.2%) plugs. There was a statistically significant postoperative decrease of TMH and TMA (P < 0.001) and postoperative epiphora Munk score (P < 0.001). Conclusion AS-OCT is a valuable, reliable, and noninvasive investigative tool that can detect the proper positioning, patency, and contents of the implanted perforated lacrimal punctal plugs in addition to measurement of TMH and TMA. Trial registration ClinicalTrials.gov ID: NCT04624022, https://clinicaltrials.gov/ct2/show/NCT04624022

show abstract

Three-snip punctoplasty versus perforated plugs for management of lacrimal punctal stenosis

Cited by 10 publications

References 17 publications

Prevalence and Determinants of Punctal Occlusion at Ophthalmology Outpatient Clinic at Tanta University Hospital

Prevalence and Determinants of Punctal Occlusion at Ophthalmology Outpatient Clinic at Tanta University Hospital

The relationship between histopathological features and surgical success in primary acquired punctal stenosis

Evaluation of implanted perforated lacrimal punctal plugs using anterior segment optical coherence tomography

Contact Info

Product

Resources

About