J Korean Ophthalmol Soc.  2017 Mar;58(3):245-250. 10.3341/jkos.2017.58.3.245.

Surgical Results of Punctoplasty Using Thermal Vaporization in Patients with Punctual Stenosis

• Park JS
• Lee TS

• KMID: 2371903
• DOI: http://doi.org/10.3341/jkos.2017.58.3.245

Abstract

PURPOSE
To evaluate the surgical results of punctoplasty using thermal vaporization in patients with punctual stenosis.
METHODS
We retrospectively reviewed the charts of 84 patients who underwent punctoplasty using thermal vaporization via a radiofrequency surgical unit (Ellman surgitron®; Ellman International Inc., Oceanside, NY, USA) from 2012 to 2015. The final surgical results included the success rates, postoperative complications, and punctual size and shape.
RESULTS
A total of 123 eyes and 219 puncta of 84 patients were included in this study. The average age was 53.5 years with a mean follow-up period of 32.2 months. Before surgery, the mean punctum diameter was 0.24 mm. After surgery, the mean punctum diameter was 2.59 mm. At last follow-up, 207 puncta (95%) were found to be patent, while 9 puncta (4%) became stenotic again. The anatomic success rate was 95%. During fluorescein dye disappearance tests after surgery, 3 eyes (2.4%) were grade 3, 5 eyes (4%) were grade 2, 3 eyes (2.4%) were grade 1, and 112 eyes (91%) were grade 0. If grades 1 or 0 were defined as functional success, then the functional success rate was 115/123 eyes (93.5%). After punctoplasty, 110 eyes (89.4%) showed no signs of epiphora. However, 5 eyes (4.1%) showed intermittent epiphora and 8 eyes (6.5%) showed persistent epiphora. According to a survey study on tearing, the functional success rate was 115/123 eyes (93.4%).
CONCLUSIONS
After punctoplasty using thermal vaporization, high anatomic and functional success rates were achieved, with the two success rates being almost identical. No significant complications were reported postoperatively.

Keyword

Punctoplasty; Punctual stenosis; Thermal vaporization

MeSH Terms

Constriction, Pathologic*
Fluorescein
Follow-Up Studies
Humans
Lacrimal Apparatus Diseases
Postoperative Complications
Retrospective Studies
Tears
Volatilization*
Fluorescein

Figure

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  Figure 1 Intraoperative photograph of widening the punctum. (A) Stenotic punctum. (B) Widened punctum.

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  Figure 2 A 60-year old woman. (A, B) Preoperative stenotic punctum were noted. She underwent punctoplasty with radiofrequency surgical unit. (C, D) 1 month after surgery, widened punctum. (E, F) One year after surgery, widened punctum were maintained.

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