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

Jun Sang Park; Tae Soo Lee

doi:10.3341/jkos.2017.58.3.245

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Park and Lee: Surgical Results of Punctoplasty Using Thermal Vaporization in Patients with Punctual Stenosis

Original Article

Journal of the Korean Ophthalmological Society 2017; 58(3): 245-250.

Published online: 15 March 2017

DOI: https://doi.org/10.3341/jkos.2017.58.3.245

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

Jun Sang Park, MD, Tae Soo Lee, MD, PhD

Nune Eye Hospital, Seoul, Korea.

Address reprint requests to Tae Soo Lee, MD, PhD. Nune Eye Hospital, #404 Seolleung-ro, Gangnam-gu, Seoul 06198, Korea. Tel: 82-2-2086-7750, Fax: 82-2-2086-7710, tsoooo@hanmail.net

Received 28 July 2016 Revised 8 November 2016 Accepted 21 February 2017

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Punctoplasty, Punctual stenosis, Thermal vaporization

Figures and Tables

Figure 1

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

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.

Table 1

Preoperative patient characteristics

Values are presented as mean ± SD or n (%).

OD = oculus dexter; UP = upper punctum; LP = lower punctum; OS = oculus sinister.

Table 2

Mean punctum size before and after operation

Values are presented as mean ± SD.

Pre Op = preoperative; Post Op = postoperative.

Table 3

Surgical results

Values are presented as n (%).

Table 4

Fluorescein dye disappearance test before and after operation

Values are presented as n (%).

Pre Op = preoperative; Post Op = postoperative.

Table 5

Questionnaire of tearing symptoms

Values are presented as n (%) unless otherwise indicated.

Pre Op = preoperative; Post Op = postoperative.

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