Use of mini-monoka stents for punctal/canalicular stenosis

Hussain, Rumana; Kanani, H Kouzeh; McMullan, Tristan F. W.

doi:10.1136/bjophthalmol-2011-300670

Cited by 56 publications

(32 citation statements)

References 8 publications

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“…Several modalities described in the literature include punctal dilatation, 1-snip punctoplasty, 2-snip punctoplasty, triangular 3-snip punctoplasty, rectangular 3-snip punctoplasty, 4-snip punctoplasty, punctal punching with Kelly's or Riess punch, punctoplasty with mitomycin-C, and inserting perforated punctal plugs, self-retaining bicanalicular stents, or mini-monoka. [5][6][7][8][9][10][11][12][13] Three-snip procedures in its modern form was described by Thomas in 1951. 14 The triangular 3-snip is a more traditional way with one cut in the vertical canaliculus, one in the horizontal canaliculus and one cut at the base.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of rectangular 3-snip punctoplasty in acquired punctal stenosis: is there a need to be minimally invasive?

Ali

Ayyar

Naik

2015

Eye

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Aim To report the clinical profiles of acquired punctal stenosis and outcomes with rectangular 3-snip punctoplasty. Methods Retrospective chart review of all patients who underwent rectangular 3-snip punctoplasty, over a 3-year period from a single surgeon's (MJA) database was performed. Data retrieved include demographics, symptomatology, prior interventions, grades of punctal stenosis, associated ocular findings, and outcomes. A minimum follow-up of 6 months following punctoplasty was considered for analysis. Success was defined as clearance of dye on functional dye disappearance test and resolution of symptoms. Results One hundred and forty five puncta of 87 eyes of 56 patients were studied. The mean age at presentations was 52 years. Puncta (71.7%; 104/145) were of grade 2 size. Epiphora was the commonest presenting symptom noted in 94.3% (82/87) of the eyes. At a minimum follow-up of 6 months, complete resolution of symptoms was achieved in 74.7% (65/87) of eyes. Eight out of 87 eyes (9.1%) failed to show any improvement secondary to lacrimal obstructions distal to the puncta. Five out of 87 (5.7%) eyes showed punctal restenosis whereas 10.3% (9/87) of the eyes had functional epiphora post punctoplasty. Conclusion Puncta of grade 2 size were the most common in this series. Although rectangular 3-snip punctoplasty is an effective and safe procedure for majority of grades 1 and 2 of acquired punctal stenosis, a higher percentages of functional epiphora and punctal restenosis in the remaining patients should propel further investigations into developing nonincisional, minimally invasive alternatives.

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Section: Introductionmentioning

confidence: 99%

Outcomes of rectangular 3-snip punctoplasty in acquired punctal stenosis: is there a need to be minimally invasive?

Ali

Ayyar

Naik

2015

Eye

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“…Mini monoka is a monocanalicular stent for the repair of canaliculus, however main complications is stent loss (29%) and stent migration (14%) as reported by previous study [7,8]. Silk stent was also used to repair lower punctum, vertical canalicular and lid lacerations compared to the present case report coinciding with similar type of injuries [9].…”

Section: Discussionmentioning

confidence: 57%

Novel Application of Vasofix Cannula for Punctal and Canalicular Laceration

Krishnacharya

Reddy

et al. 2019

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Aim: Purpose of present study is to investigate the efficacy of vasofix cannula in preserving punctum position and canalicular patency. Presentation of Case: A thirty four year old male patient presented with multiple right both eyelid injuries consisting of lower punctum, vertical and horizontal canalicular laceration, lower eyelid tear with tarsal plate fracture with pretarsal orbicularis muscle splitting, laceration near lateral canthus running for about an inch horizontally and vertical upper lid laceration near upper punctum inflicted by flying zinc sheet at work place. Examination revealed normal and intact ocular functions. Ocular movements were full with unremarkable fundoscopy. CT orbit showed no orbital fractures and intraocular foreign body. Vasofix cannula 24 Gauge inserted into lower punctum and canaliculus, and anchored to lid margin by vicryl 10-0 along with lid laceration repair under local anesthesia. Discussion: Punctal position, canalicular support and patency were maintained with no infection or extrusion. There was no epiphora or ocular irritation during 10 weeks of follow up. Conclusion: This case study describes management of monopunctal and horizontal as well vertical canalicular laceration by vasofix cannula acting as a stent. Anatomical and physiological functions restored with acceptable cosmetic appearance. Added advantage is that all time availability of cannula in all operation theatres. Although Vasofix cannula is semi flexible in nature can be used as a stent for canalicular intubation purpose.

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“…Punctal stenosis can be treated with snip punctoplasty, but this does not address canalicular stenosis and may disrupt muscles along the canaliculus important for pumping of tears through the nasolacrimal system. 1 Intubation of the lacrimal drainage system has been described as an alternative method of treatment. 2 However, monocanalicular stents block flow through the punctum and cannot support the medial canthus.…”

Section: Introductionmentioning

confidence: 99%

“…Traditional bicanalicular systems such as Ritleng (FCI Ophthalmics, Pembroke, MA) or Crawford (FCI Ophthalmics, Pembroke, MA) can result in iatrogenic trauma to the canaliculi, distal nasolacrimal duct or nasal anatomy during placement. 1 In addition, these systems require retrieval of the stent within the nose during placement, often necessitating general anesthesia to protect the airway from bleeding. 3 The Kaneka Lacriflow CL (Lacriflow) (Kaneka Pharma America, New York, NY) system is a revised Nunchakustyle tube with a central rod segment and two thicker tube segments, each with a slit several millimeters from the distal end ( Figure 1).…”

Section: Introductionmentioning

confidence: 99%

<p>Bicanalicular Intubation with the Kaneka Lacriflow for Proximal Lacrimal Drainage System Stenosis</p>

DeParis¹,

Hougen²,

Rajaii³

et al. 2020

OPTH

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Purpose: The Kaneka Lacriflow CL (Lacriflow) bicanalicular lacrimal intubation system was evaluated as a self-retaining alternative to traditional modalities for stenting and dilation of the lacrimal drainage system in proximal lacrimal drainage system stenosis. Patients and Methods: A retrospective chart review was conducted to assess the use of the Lacriflow system for treatment of patients with punctal and canalicular stenosis. Anesthesia type, operative time, and complications were assessed. Results: In the time period evaluated, a total of 72 Lacriflow stents were placed in 45 patients, most commonly under intravenous sedation. Stents were left in place for a mean of 145 days, with 9 stents left in place for more than 1 year, and a mean follow-up time of 263 days. Early complications within 90 days included prolapse in 1 stent, symptomatic colonization for 2 stents, and corneal abrasion in 1 stent in a patient with anterior basement membrane dystrophy. Five additional stents developed colonization in the late postoperative period (four of which were more than 1 year after stent placement). The overall complication rate (per stent) at 3 months after surgery was 5.6% and at all follow-up time points was 13.9%. Operative times were significantly shorter for a cohort of patients undergoing bicanalicular intubation with the Ritleng system (P = 0.015). Conclusion: The Lacriflow bicanalicular stent can be easily placed without general anesthesia. Complication rates are comparable to other bicanalicular intubation systems, but increase with longer time that stents are left in place.

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Use of mini-monoka stents for punctal/canalicular stenosis

Abstract: Mini-monoka punctocanaliculoplasty is an effective, safe, simple and relatively non-invasive treatment strategy for the management of epiphora secondary to punctal and/or canalicular stenosis.

Cited by 56 publications

References 8 publications

Outcomes of rectangular 3-snip punctoplasty in acquired punctal stenosis: is there a need to be minimally invasive?

Outcomes of rectangular 3-snip punctoplasty in acquired punctal stenosis: is there a need to be minimally invasive?

Novel Application of Vasofix Cannula for Punctal and Canalicular Laceration

<p>Bicanalicular Intubation with the Kaneka Lacriflow for Proximal Lacrimal Drainage System Stenosis</p>

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