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A Simple Surgical Approach for the Management of Acquired Severe Lower Punctal Stenosis
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 ac...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348839/ https://www.ncbi.nlm.nih.gov/pubmed/30733874 http://dx.doi.org/10.1155/2019/3561857 |
Sumario: | 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. |
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