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. 2021 Jun 18;14(6):849-854.
doi: 10.18240/ijo.2021.06.09. eCollection 2021.

Rectangular 3-snip punctoplasty versus punch punctoplasty with silicone intubation for acquired external punctal stenosis: a prospective randomized comparative study

Xin Cao  1   2 , Zi-Zhong Hu  1 , Ying Wu  2 , Yu Song  2 , Qing-Huai Liu  1
Affiliations

Rectangular 3-snip punctoplasty versus punch punctoplasty with silicone intubation for acquired external punctal stenosis: a prospective randomized comparative study

Xin Cao et al. Int J Ophthalmol. .

Abstract

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 12mo 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 12mo (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.

Keywords: Kelly punch; acquired external punctal stenosis; punctoplasty.

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Figures

Figure 1
Figure 1. Scatter plots demonstrating the correlation between TMH and Munk score at 6 and 12mo postoperative follow-up points.
See this image and copyright information in PMC

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