Factors affecting outcome of punctoplasty surgery: a review of 205 cases

Abstract

This is the largest reported consecutive case series of isolated punctoplasty surgery. Overall anatomical success was high and the surgical technique, grade of surgeon and choice of postoperative medication did not significantly alter the outcome. Without adequate preoperative assessment a significant proportion of patients may undergo surgery inappropriately. Even with an adequate assessment anatomical success is not always followed by resolution of epiphora.

Long-term outcomes of punch punctoplasty with Kelly punch and review of literature

“…Literature review shows a competitive edge of punch punctoplasty compared with other punctoplasty techniques as displayed in Table 3. Compared with the variable rates of success with the snip procedure, quoted to range from 31.2 to 92%, [15][16][17][18][19][20] the success rate with punch punctoplasty seems to be superior. It is also comparable to the success rates of combined procedures with bicanalicular stents or mini-monoka stent, 3,9 suggesting that a more complicated combined procedure for punctoplasty may not confer extra advantage.…”

“…In our study, functional and anatomical success rates are comparable, but literature reviews show anatomical success commonly exceeding functional success. 2,9,12,15,18,22 The importance of appropriate preoperative workup is emphasized to improve a patient's symptoms. As multiple factors may contribute to epiphora, it is important to determine the major causative factor in symptomatic epiphora.…”

Punctal stenosis: definition, diagnosis, and treatment

“…In a large retrospective study of 169 patients with appropriate preoperative evaluation, two-snip punctoplasty was compared with three-snip punctoplasty 46. A two-snip procedure entails a vertical cut to the medial and lateral wall of the punctum, followed by removal of the tissue left between the incisions.…”

Use of mini-monoka stents for punctal/canalicular stenosis

“…Although the procedure often leads to symptomatic improvement,3 4 it does not address canalicular disease which often coincides with punctal stenosis. An alternative procedure used for both acquired punctal and canalicular stenosis is that of lacrimal duct silicone tube insertion.…”