Xin Cao1,2, Zi-Zhong Hu1, Ying Wu2, Yu Song2, Qing-Huai Liu1. 1. Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China. 2. Department of Ophthalmology, the Second Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China.
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. International Journal of Ophthalmology Press.
RCT Entities:
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. International Journal of Ophthalmology Press.
Entities:
Keywords:
Kelly punch; acquired external punctal stenosis; punctoplasty
Authors: Mun Chong Hur; Sang Wook Jin; Mi Sook Roh; Woo Jin Jeong; Won Yeol Ryu; Yoon Hyung Kwon; Hee Bae Ahn Journal: Korean J Ophthalmol Date: 2017-10