Three Different Modalities for Treatment of Inflammatory Punctal Stenosis

Comparative Study Between Three Different Modalities for Treatment of Inflammatory Punctal Stenosis

This study aimed to compare the efficacy of three various modalities of treatment of inflammatory punctal stenosis (Punctal dilatation alone, combined punctal dilatation with topical medications, or peri-punctal injection of Triamcinolone acetonide)

Acquired punctal stenosis is a condition in which the external opening of the lacrimal canaliculus, located in the nasal part of the palpebral margin, is narrowed or occluded. This condition results from chronic inflammation of the external punctum, leading to gradual fibrotic changes in the ostium, followed by progressive occlusion of the duct.

Different modalities were described for the treatment of acquired punctual stenosis. Repeated dilatation of the stenotic punctum is a simple procedure that may provide temporary improvement of the symptoms, but restenosis is common unless additional procedures are performed. Many other methods were used to augment punctual size, including 1-snip, 2-snip, and 3-snip punctoplasty, supplemented with adding sutures or Mini-Monoka insertion and punch punctoplasty.

Inclusion Criteria:

• Age from 33 to 75.
• Both sexes.
• Patients with inflammatory punctal stenosis or occlusion complaining of symptomatic epiphora.

Exclusion Criteria:

• Subjects with previous lacrimal surgeries.
• Subjects with lid margin malposition such as ectropion, entropion, or lid retraction.
• Subjects with medial lid masses obscuring the punctum.
• Subjects with a history of ocular trauma involving the medial aspect of the lid margin.