Clinical and scintigraphic comparison of silicone and polyvinylpyrrolidone coated silicone perforated plugs

Abstract

Background/aim-Isolated stenosis of the lacrimal punctum is a frequent cause of epiphora. Treatment relies on surgical opening or dilatation with bi-or monocanalicular prosthesis. Recently, silicone perforated punctum plugs (PPP) were proposed. The drawback with these silicone PPP was that secretions accumulate in the central orifice blocking the spontaneous flow of tears. A modification of the surface of the PPP using polyvinylpyrrolidone (PVP) was thus proposed. The aim was to compare silicone PPP with new PVP surface treated PPP. Methods-A prospective study was conducted of 20 patients with dilatable stenosis of the lacrimal puncta who developed epiphora. Epiphora, tolerance, implantation of the PPP, and lacrimal drainage were evaluated using scintigraphy of the lacrimal ducts. Results-The raw data and statistical analysis showed evidence of a superior performance of PVP surface treated PPP. Conclusion-Long term evaluation of the advantages or risks of PVP plugs and comparison with microsurgical punctoplasty are warranted.

Management of acquired punctal stenosis with perforated punctal plugs

“…Pure punctum stenosis treatment relies on punctum dilatation, surgical opening or punctum stenting with canalicular tubes or punctum plugs. However canalicular tubing is unnecessary if there is no intracanalicular pathology 5,6,8–12 …”

Intubationssysteme in der Tränenwegchirurgie – eine aktuelle Übersicht

“…Einige verfügen über eine zusätzliche PVP-Beschichtung. Einen Vorteil der PVP-Beschichtung scheint es zumindest bei perforierten Punctum Plugs zu geben [45]. Hier scheint die PVP-Beschichtung zu einer besseren Durchgängigkeit und damit zu einer erhöhten Reduktion der Epiphorasymptomatik zu führen [45].…”

“…Einen Vorteil der PVP-Beschichtung scheint es zumindest bei perforierten Punctum Plugs zu geben [45]. Hier scheint die PVP-Beschichtung zu einer besseren Durchgängigkeit und damit zu einer erhöhten Reduktion der Epiphorasymptomatik zu führen [45]. Für andere Intubate dagegen ist der Vorteil einer PVP-Beschichtung nicht eindeutig belegt oder gar nicht untersucht.…”

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

“…Malet et al 14 reported success in 75% of cases demonstrating acquired punctal stenosis with PVP-coated PPP after 6 months of follow-up. In this study, the plugs were left in place for 2 months, and a patency rate of 84.1% was achieved after a mean follow-up period of 19 months, demonstrating a satisfactory long-term success rate.…”

“…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. 14,15 The aim of this study was to describe the clinical presentations of acquired punctal stenosis, detail our implantation technique, and determine the long-term success rates of PPP for the management of acquired punctal stenosis.…”