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Kim and Kim: The Effect of Punctoplasty with Pigtail Probe for Canalicular Intubation in Patients with Punctal Obstruction
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(9): 1219-1225.

Published online: 17 September 2012

DOI: https://doi.org/10.3341/jkos.2012.53.9.1219

The Effect of Punctoplasty with Pigtail Probe for Canalicular Intubation in Patients with Punctal Obstruction

In Geun Kim, MD, Sang Soo Kim, MD

Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea.

Address reprint requests to Sang Soo Kim, MD. Department of Ophthalmology, Maryknoll Medical Center, #121 Junggu-ro, Jung-gu, Busan 600-730, Korea. Tel: 82-51-461-2469, Fax: 82-51-462-3534, eyerheu@hanafos.com

Received 23 December 2011       Accepted 5 August 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To assess the surgical results of a punctoplasty with insertion of a silicone tube using a pigtail probe for the management of acquired punctal obstruction.

Methods

The medical records of 61 patients who underwent an operation for the management of punctual obstruction were reviewed. After punctal dilation, fluorescein dye disappearance test was performed to evaluate its efficacy. In the case of no functional delay after punctal dilation, three-snip punctoplasty with a silicone tube using a pigtail probe was performed. In the case of a functional delay, three-snip punctoplasty with a silicone tube into the nasolacrimal duct was performed.

Results

The surgical success over 1 year was 39.1% in patients who underwent only three-snip punctoplasty, 79.2% in patients who underwent a three-snip punctoplasty with a silicone tube insertion into the nasolacrimal duct, and 85.7% in patients who underwent a three-snip punctoplasty with canalicular intubation using a pigtail probe.

Conclusions

The use of a pigtail probe for canalicular intubation together with a three-snip punctoplasty is useful to prevent the recurrence of punctal obstruction.

Keywords: Epiphora, Pigtail probe, Punctal obstruction, Punctoplasty, Silicone tube insertion

Figures and Tables

Figure 1
(A) A vertical snip incision is made on the medial aspect of the posterior rim of the puctum. (B) Pigtail probe is passed along the canaliculus and exits at the opposite puctum. (C) 6-0 prolene stitch is threaded onto the probe which is then reversed leaving a 6-0 prolene stitch in the system. (D) Silicone tube is threaded over a 6-0 prolene stitch. (E) The 6-0 prolene suture is tied and the silicone tubing is rotated so the knot site is at the level of the common canaliculus. (F) Silicone tubing with a 6-0 prolene stitches inside it in the medial canthus.
jkos-53-1219-g001
Table 1
Clinical results of three-snip punctoplasty and nasolacrimal duct (NLD) silicone tube intubation and canaliculus silicone tube intubation within 1 year
jkos-53-1219-i001

p-value = 0.004 by Chi-square test.

Table 2
Clinical results of three-snip punctoplasty and nasolacrimal duct (NLD) silicone tube intubation and canaliculus silicone tube intubation over 1 year
jkos-53-1219-i002

p-value = 0.003 by Chi-square test.

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