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ISSN 1561-3070 (Electronic)

2020, Number 2

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Rev Cub Oftal 2020; 33 (2)

Modified two-snip punctoplasty for stenosis of inferior lacrimal points and canaliculi

Ortíz RDL, Abreu PFA

Language: Spanish
References: 19
Page: 1-11
PDF size: 276.59 Kb.


ABSTRACT

Objective: Determine the results achieved by modified two-snip punctoplasty in the management of patients with stenosis of inferior lacrimal points and canaliculi.
Methods: A retrospective descriptive study was conducted of a case series at Comandante Manuel Fajardo Clinical Surgical University Hospital from January 2016 to December 2018. The sample was 22 patients (38 eyes) undergoing the surgical technique. The variables studied were age, sex, skin color, bilaterality, anatomical location of the obstruction, personal pathological antecedents, complications and final functional evaluation.
Results: Of the total 22 patients, 17 were in the 60-79 years age group, 72.7% were female and 86.4% were white. Blepharitis was the main ophthalmological antecedent (18.2%). Obstruction was bilateral in 72.7% of the cases, fundamentally at the lacrimal punctum (16 cases). 86.8% did not have any postoperative complication, whereas 3 presented extrusion of the silicone tutor. These were related to failure in the final result. Surgery was successful in 92.1% of the cases.
Conclusions: Lacrimal duct stenosis prevails in white skin women aged over 60 years without reported pathological antecedents. The disorder is more common at the lacrimal punctum. The surgical technique used achieves excellent results with minimum complications.


REFERENCES

  1. Mainville N, Jordan D. Etiology of tearing: A retrospective analysis of referrals to a tertiary care oculoplastics practice. Ophthal Plast Reconstr Surg. 2011;27:155.

  2. Chong M, Wook S, Sook M, Jin W, Yeol W, Hyung Y, Bae H. Classification of lacrimal punctal stenosis and its related histopathological feature in patients with epiphora. Korean J Ophthalmol. 2017;31(5):375-82.

  3. Primelles R, Gómez N, Arrontes D, Torres O, Martínez IY. Caracterización clínico-epidemiológica de la estenosis de los puntos lagrimales. Rev Cienc Med Pinar del Río 2016;20(2):194-9.

  4. Ali MJ, Mishra DK, Baig F, et al. Punctal stenosis: histopathology, immunology and electron microscopic features - a step towards unraveling the mysterious etiopathogenesis. Ophthalmol Plast Reconstr Surg. 2015;31:98-102.

  5. Soiberman U, Kakizaki H, Selva D, Leibovitch I. Punctal stenosis: definition, diagnosis and treatment. Clin Ophthalmol. 2012;6:1011-8.

  6. Dolin SL, Hecht SD. The punctum pucker procedure for stenosis of the lacrimal punctum. Arch Ophthalmol. 1986;104:1086-7.

  7. Lam S, Tessler HH. Mitomycin C as adjunct therapy in correcting iatrogenic punctal stenosis. Ophthalmic Surg. 1993;24:123-4.

  8. Chak M, Irvine F. Rectangular 3 snip punctoplasty outcomes: preservation of lacrimal pump in punctoplasty surgery. Ophthalmol Plast Reconstr Surg. 2009;25:134-5.

  9. Caesar RH, McNab AA. A brief history of punctoplasty: the three snip revisited. Eye. 2005;19:16-8.

  10. Ansart AF, Sánchez SV, Tovilla JL. Dacriointubación cerrada y tubo de silicona como tratamiento de la obstrucción adquirida de vía lagrimal alta en adultos. Rev Mex Oftalmol. 2006;80(5):254-9.

  11. Port AD, Chen YT, Lelli GJ. Histopathologic changes in punctal stenosis. Ophthalmic Plast Reconstr Surg. 2013;29(3):201-4.

  12. Abd El Ghafar AS, El-Kannishy AM, Elwan MM, Sabry D, Kishk HM, Elhefney EM. Perforated punctal plugs with adjuvant use of mitomycin-C in management of acquired external punctal stenosis grades 0 and 1. Can J Ophthalmol. 2017;52(6):606-10.

  13. Dudeja G, Khazaei HM, Bhujang K, Piplani B. Recent advances in management of acquired external punctal stenosis. Delhi J Ophthalmol. 2015;26(2):2.

  14. Mansur C, Pfeiffer ML, Esmaeli B. Evaluation and management of chemotherapy-induced epiphora, punctal and canalicular stenosis, and nasolacrimal duct obstruction. Ophthalmic Plast Reconstr Surg. 2017;33(1):9-12.

  15. Kazuyoshi O, Takashi U. Lacrimal obstruction in adults. Ophthal Plast Reconstr Surg. 2017;33(2):2.

  16. Ali MJ, Ayyar A, Naik MN. Outcomes of rectangular 3-snip puntoplasty in acquired punctal stenosis: is there a need to be minimally invasive? Eye. 2015;29:515-8.

  17. Delgado JL, Montesinos B, Pérez J, Re B, Moreno JM. Puntoplastia: nuestra técnica para solucionar la epífora por epitelización del punto lagrimal inferior. Arch Soc Canar Oftalmol. 2001;12:119-21.

  18. Hussain RN, Kanani H, McMullan T. Use of minimonoka stents for punctal and canalicular stenosis. Br J Ophthalmol. 2012;96:671-3.

  19. Singh S, Ali MJ, Mohamed A. Comparison of outcomes of 3-Snip punctoplasty versus simple punctal dilatation with monocanalicular intubation for acquired punctal stenosis. Ophthalmic Plast Reconstr Surg. 2018;34(4):375-7.




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