Management of acquired punctal stenosis with perforated punctal plugs

Özgür, Özlen Rodop; Akçay, Levent; Tutas, Nesrin; Karadağ, Onur

doi:10.1016/j.sjopt.2015.04.001

Cited by 21 publications

(31 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In previous studies [6, 15, 22, 23], perforated lacrimal plugs were used to keep the punctum opened in cases of punctal stenosis. This was not applicable in the current study because all our cases were of grade 0 and needed an incision to open the occluded punctum.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Simple Surgical Approach for the Management of Acquired Severe Lower Punctal Stenosis

Mandour

Said-Ahmed

Khairy

et al. 2019

Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose Evaluation of using pigtail probe to detect and open severely stenosed lower lacrimal punctum followed by self-retaining bicanalicular intubation. Study design A prospective nonrandomized clinical study. Methods The study included 24 patients with severe lower punctal stenosis (grade 0 according to Kashkouli scale) attending at Menoufia University Hospitals. The upper punctum and canaliculus were patent. All patients were complaining of epiphora and had a thorough ophthalmological examination including dye disappearance test and slit-lamp examination. Pigtail probe was used from patent upper punctum to detect the lower stenosed punctum which was opened with a scalpel. Syringing of the lower lacrimal passages was done to confirm its patency, and self-retaining silicone bicanalicular stent was inserted. The silicone tube was left in place for 6 months before it was removed. Patients were then followed-up for 1 year after the surgery. Results One year after surgery, epiphora was absent (grade 0) in 16 eyes (66.7%) and was present only occasionally (grade 1) in 4 eyes (16.7%). The difference from preoperative epiphora was statistically significant. One year after surgery, fluorescein dye disappearance time was grade 1 (<3 minutes) in 20 cases (83.3%), and grade 2 (3–5 minutes) in 4 cases (16.7%). There was a statistically significant difference compared with preoperative results. Conclusion Using the pigtail probe is effective in treatment of severe punctal stenosis. Maintaining the punctal opening and prevention of restenosis can be achieved by using self-retaining bicanalicular stent after confirmation of nasolacrimal duct patency. This trial is registered with NCT03731143.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The dye disappearance test was performed with a drop of 2% fluorescein sodium dye in the inferior fornix. Assessment after 5 minutes of the remaining dye in the tear meniscus was done, and results were graded (Table 2) [15].…”

Section: Methodsmentioning

confidence: 99%

A Simple Surgical Approach for the Management of Acquired Severe Lower Punctal Stenosis

Mandour

Said-Ahmed

Khairy

et al. 2019

Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…Slit lamp examination was done to exclude causes of increased lacrimation, to evaluate tear meniscus height (TMH) and to evaluate punctal orifices position, shape, and grading of stenosis according to Ozgur et al. 12 (Table 2). Fluorescein dye disappearance test (FDDT) was done using one drop of 2% fluorescein sodium instilled into the anesthetized lower fornix.…”

Section: Methodsmentioning

confidence: 99%

“…FDDT was graded according to Ozgur et al. ; 12 scale consistent with the time of dye clearance with Grade 1 is <3 minutes, Grade 2 is 3–5 minutes, and Grade 3 is >5 minutes. Objective improvement was considered by postoperative decrease of the grade of FDDT.…”

Section: Methodsmentioning

confidence: 99%

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

Tamer

Abdelghany

Elshafei

et al. 2020

European Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose To compare rectangular three-snip punctoplasty and polyvinylpyrrolidone-coated perforated punctal plugs for treatment of acquired lacrimal punctal stenosis. Patients and methods In a prospective comparative non-randomized interventional study, 80 eyes with acquired lacrimal punctal stenosis were classified into two groups. Group A was treated by insertion of polyvinylpyrrolidone-coated perforated punctal plugs (FCI ophthalmics)™ and Group B was treated by rectangular three-snip punctoplasty. The study was done in Minia University Hospital between January 2018 and April 2019. Exclusion criteria included allergic punctal stenosis, lid malposition, and lacrimal obstruction distal to the punctum. All patients were subjected to complete history taking, slit lamp examination of tear meniscus height, fluorescein dye disappearance test, punctal position, shape, size, grading of stenosis, and grading of epiphora. Results The mean age of the patients was 43.85 ± 14.93 years. They were 30 females and 10 males. Eepiphora Grade 3 or 4, improved postoperatively to Grade 0 or 1 in 97.5% of eyes in Group A versus 55% of eyes in Group B. All eyes (100%) in Group A versus 21 eyes (52.5%) in Group B improved regarding fluorescein dye disappearance test grade ( p < 0.001). Restenosis did not occur after plug removal, while it occurred in 10% of eyes subjected to three-snip punctoplasty. Conclusion Perforated punctal plugs and three-snip punctoplasty are safe and effective in treatment of punctal stenosis. However, perforated plugs are less invasive, better tolerated, and have more stable results compared to three-snip punctoplasty.

show abstract

“…Fluorescein dye disappearance test (FDDT) where a drop of sterile 2% uorescein solution or a moistened uorescein strip is instilled into the conjunctival fornices and tear meniscus was observed after 5 minutes with the help of cobalt-blue lter and results were graded according to Ozgur et al, scale depending on the time of dye clearance as follows; grade1 (<3 minutes), grade2 (3-5 minutes) & grade3 (>5 minutes). [14] Diagnostic probing and syringing were done to ensure anatomically patent nasolacrimal system and to detect any obstruction distal to the punctum.…”

Section: Introductionmentioning

confidence: 99%

A Comparison between Placement of three interrupted sutures after Triangular Three-snip Punctoplasty vs conventional Triangular Three-snip Punctoplasty for treatment of lower punctal stenosis

Abdulhady

Khairy

Awara

et al. 2021

Preprint

View full text Add to dashboard Cite

Aim is to evaluate surgical outcome of Triangular Three-snip Punctoplasty (TSP) with three interrupted sutures and compare it to conventional Triangular Three-snip Punctoplasty (TSP) in treatment of acquired lower punctal stenosis. Methods This prospective study included 40 eyelids of 24 patients with acquired lower punctal stenosis grade 1 or grade 2 were classified in two groups. Group A was treated by triangular 3-snip punctoplasty of the lower punctum followed by three interrupted sutures at the posterior ampulla and group B was treated by conventional triangular 3-snip punctoplasty of the lower punctum. Grade of epiphora and grade of FDDT were measured preoperative then post-operative after 1 week, 1 month, 3 months and 6 months. Success was defined as postoperative improvement of epiphora and FDDT grading with no restenosis to occur. Results from 20 eyelids in group A, 16 cases showed success (80%) with patent puncta, 2 cases (10%) showed no change and 2 cases (10%) showed failure with restenosis. While from 20 eyelids in group B, 14 cases showed success (60%) with patent puncta, 4 cases (20%) showed no change and 4 cases (20%) showed failure with restenosis. Conclusion proposed triangular 3-snip punctoplasty of the lower punctum followed by three interrupted sutures seems to have better results compared to conventional triangular 3-snip punctoplasty of the lower punctum in treatment of grade 1 or 2 lower punctal stenosis.

show abstract

Management of acquired punctal stenosis with perforated punctal plugs

Abstract: Punctum stenosis is one of the several disorders that cause lacrimal drainage obstruction. Perforated punctal plugs are found convenient and effective in managing punctal stenosis.

Cited by 21 publications

References 14 publications

A Simple Surgical Approach for the Management of Acquired Severe Lower Punctal Stenosis

A Simple Surgical Approach for the Management of Acquired Severe Lower Punctal Stenosis

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

A Comparison between Placement of three interrupted sutures after Triangular Three-snip Punctoplasty vs conventional Triangular Three-snip Punctoplasty for treatment of lower punctal stenosis

Contact Info

Product

Resources

About