Acquired external punctal stenosis: Surgical management and long-term follow-up

Kashkouli, M.B. and Beigi, B. and Astbury, N. (2005) Acquired external punctal stenosis: Surgical management and long-term follow-up. Orbit, 24 (2). pp. 73-78.

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Text Orbit Volume 24 issue 2 2005 [doi 10.1080_01676830490916055] Kashkouli, Mohsen Bahmani; Beigi, Bijan; Astbury, Nick -- Acquired External Punctal Stenosis- Surgical Management and Long-Term Follow-Up.pdf Download (412kB) | Preview

Abstract

Purpose: To introduce and assess the results of a long-term follow-up of a one-snip punctoplasty with monocanalicular stent (Mini Monoka) for acquired external punctal stenosis (AEPS) with and without associated internal punctal and canalicular stenosis. Design: Prospective non-comparative interventional case series. Methods: Thirty-five eligible patients (53 eyes) with AEPS underwent a horizontal one-snip punctoplasty and Mini Monoka tube insertion by or under supervision of a consultant Oculoplastic surgeon from June 1999 to May 2002. Diagnostic probing and irrigation were performed before operation and after operation at the last follow-up. Patients with canalicular obstruction, nasolacrimal duct stenosis and obstruction, and those with less than 6 months' follow-up were excluded. The Chi-square (X2), Fisher's exact, Pearson correlation, and multiple logistic regression analysis tests, with 95 confidence interval when appropriate, were used for statistical analysis. Results: The age range was 39 to 90 years (mean: 67.2, SD: 11.8, SE: 2). Twenty-seven patients (77.1) were female. There was a normal canalicular system in 21 (39.6), lower canalicular stenosis in 10 (18.8), and internal punctal stenosis in 22 (41.5) eyes. Postoperative follow-up was from 6 to 41 months (mean: 18.5, SD: 9.2, SE: 1.2). There was a 77.4 complete functional success, 7.5 partial functional success, and 96.2 anatomical success at the last follow-up. The success rate was not significantly different between the eyes with and without preoperative internal punctal and canalicular stenosis (p = 0.4). The lower success rate was significantly correlated with a final abnormal probing and irrigation (p < 0.01). Conclusion: The use of a monocanalicular Mini Monoka stent together with a one-snip punctoplasty is helpful to prevent the recurrence of punctal stenosis in the healing phase and addresses the associated internal punctal and canalicular stenosis. Copyright © 2005 Taylor & Francis Inc.

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