This is a retrospective, noncomparative analysis of a case series to explore the safety and effectiveness of retrograde canaliculotomy and punctoplasty for treating epiphora due to upper and lower lacrimal punctal occ...This is a retrospective, noncomparative analysis of a case series to explore the safety and effectiveness of retrograde canaliculotomy and punctoplasty for treating epiphora due to upper and lower lacrimal punctal occlusion. During the procedure, the horizontal portion of the normal lower canaliculus was identified;the corresponding punctum was reconstructed via retrograde canaliculotomy and punctoplasty. Intubation was performed to prevent postoperative reocclusion. Patients were followed up for 12 to 24 mo. A total of 16 patients with unilateral upper and lower lacrimal punctal occlusion were included. Satisfactory outcomes were achieved: all 16 patients exhibited improvement of epiphora;31 rebuilt punctal openings and canaliculi achieved recanalization. Only one upper punctal opening could not be reconstructed because the corresponding canaliculus exhibited severe injury. No significant complications occurred as a result of the treatments. Retrograde canaliculotomy and punctoplasty appears to effective, safe, and minimally invasive for treatment of upper and lower punctal occlusion.展开更多
AIM:To evaluate the effectiveness of rectangular 3-snip punctoplasty versus punch punctoplasty via Kelly punch with silicone intubation for the management of acquired external punctal stenosis(AEPS).METHODS:A prospect...AIM:To evaluate the effectiveness of rectangular 3-snip punctoplasty versus punch punctoplasty via Kelly punch with silicone intubation for the management of acquired external punctal stenosis(AEPS).METHODS:A prospective,randomized,comparative study was performed on 123 eyes of 94 patients with AEPS.Patients were recruited into either group of rectangular 3-snip punctoplasty(group A)or group of punch punctoplasty with silicone intubation(group B).Outcomes measured were Munk score,grade of punctal stenosis,fluorescein dye disappearance time test(FDDT)and tear meniscus height(TMH)6 and 12 mo after surgery.RESULTS:Twelve months after surgery,Munk score,FDDT and TMH significantly decreased in both groups compared with the baseline(all P<0.05),and grade of punctal stenosis increased significantly(P<0.05).The grade of punctal stenosis,Munk score,FDDT and TMH were better in group B compared with group A at 6 or 12 mo(all P<0.05).There was a positive correlation between TMH and Munk score(R=0.655,P<0.001).At the last followed-up,anatomical success was noted in 96.7%eyes in group A and 98.4%eyes in group B(P=0.613).CONCLUSION:Punch punctoplasty via Kelly punch with silicone intubation achieves better outcomes than rectangular 3-snip punctoplasty.The new technique is a simple,minimally invasive,with high anatomical and functional success in patients with AEPS.展开更多
Background: Cyclosporine A (CsA) is an inhibitor of calcineurin that prevents T-cell production of inflammatory cytokines and disrupts the immune-mediated inflammatory response that plays a crucial mechanism in puncta...Background: Cyclosporine A (CsA) is an inhibitor of calcineurin that prevents T-cell production of inflammatory cytokines and disrupts the immune-mediated inflammatory response that plays a crucial mechanism in punctal stenosis. Purpose: To evaluate the clinical outcomes and tolerances of CsA in treating epiphora in eyes with punctal stenosis. Study Design: Prospective study. Methods: The study included patients who presented with symptomatic epiphora associated with lower punctal stenosis during the period between July 2019 and December 2020. Patients were treated with topical 0.05% CsA on twice daily dose with topical preservative-free artificial tears Q.I. D. Patients were followed up monthly for at least 3 months by Munk epiphora grading, Fluorescein dye disappearance test (FDT) and evaluation of the patient satisfaction. Results: A total of 26 patients with 47 eyes were included in the study with a mean age of 55.1 ± 10.24 years. All the eyes had grade 0 lower punctal stenosis with grade 4 on Munk grading and grade 3 in FDT. There was a statistically significant difference in the Munk grading and FDT along the follow-up period compared to the baseline values (p Conclusion: CsA can control the inflammation of the conjunctival sac and restore the integrity of the ocular surface with subsequent symptomatic relief of the epiphora in eyes with punctal stenosis.展开更多
基金Supported by the National Natural Science Foundation of China(No.81600766 No.31600971)+1 种基金Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology,the Science and Technology Commission of Shanghai(No.17DZ2260100)Shanghai Young Doctor Training Program
文摘This is a retrospective, noncomparative analysis of a case series to explore the safety and effectiveness of retrograde canaliculotomy and punctoplasty for treating epiphora due to upper and lower lacrimal punctal occlusion. During the procedure, the horizontal portion of the normal lower canaliculus was identified;the corresponding punctum was reconstructed via retrograde canaliculotomy and punctoplasty. Intubation was performed to prevent postoperative reocclusion. Patients were followed up for 12 to 24 mo. A total of 16 patients with unilateral upper and lower lacrimal punctal occlusion were included. Satisfactory outcomes were achieved: all 16 patients exhibited improvement of epiphora;31 rebuilt punctal openings and canaliculi achieved recanalization. Only one upper punctal opening could not be reconstructed because the corresponding canaliculus exhibited severe injury. No significant complications occurred as a result of the treatments. Retrograde canaliculotomy and punctoplasty appears to effective, safe, and minimally invasive for treatment of upper and lower punctal occlusion.
文摘AIM:To evaluate the effectiveness of rectangular 3-snip punctoplasty versus punch punctoplasty via Kelly punch with silicone intubation for the management of acquired external punctal stenosis(AEPS).METHODS:A prospective,randomized,comparative study was performed on 123 eyes of 94 patients with AEPS.Patients were recruited into either group of rectangular 3-snip punctoplasty(group A)or group of punch punctoplasty with silicone intubation(group B).Outcomes measured were Munk score,grade of punctal stenosis,fluorescein dye disappearance time test(FDDT)and tear meniscus height(TMH)6 and 12 mo after surgery.RESULTS:Twelve months after surgery,Munk score,FDDT and TMH significantly decreased in both groups compared with the baseline(all P<0.05),and grade of punctal stenosis increased significantly(P<0.05).The grade of punctal stenosis,Munk score,FDDT and TMH were better in group B compared with group A at 6 or 12 mo(all P<0.05).There was a positive correlation between TMH and Munk score(R=0.655,P<0.001).At the last followed-up,anatomical success was noted in 96.7%eyes in group A and 98.4%eyes in group B(P=0.613).CONCLUSION:Punch punctoplasty via Kelly punch with silicone intubation achieves better outcomes than rectangular 3-snip punctoplasty.The new technique is a simple,minimally invasive,with high anatomical and functional success in patients with AEPS.
文摘Background: Cyclosporine A (CsA) is an inhibitor of calcineurin that prevents T-cell production of inflammatory cytokines and disrupts the immune-mediated inflammatory response that plays a crucial mechanism in punctal stenosis. Purpose: To evaluate the clinical outcomes and tolerances of CsA in treating epiphora in eyes with punctal stenosis. Study Design: Prospective study. Methods: The study included patients who presented with symptomatic epiphora associated with lower punctal stenosis during the period between July 2019 and December 2020. Patients were treated with topical 0.05% CsA on twice daily dose with topical preservative-free artificial tears Q.I. D. Patients were followed up monthly for at least 3 months by Munk epiphora grading, Fluorescein dye disappearance test (FDT) and evaluation of the patient satisfaction. Results: A total of 26 patients with 47 eyes were included in the study with a mean age of 55.1 ± 10.24 years. All the eyes had grade 0 lower punctal stenosis with grade 4 on Munk grading and grade 3 in FDT. There was a statistically significant difference in the Munk grading and FDT along the follow-up period compared to the baseline values (p Conclusion: CsA can control the inflammation of the conjunctival sac and restore the integrity of the ocular surface with subsequent symptomatic relief of the epiphora in eyes with punctal stenosis.
