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Rectangular 3-snip punctoplasty outcomes: preservation of the lacrimal pump in punctoplasty surgery.
Ophthalmic Plast Reconstr Surg 2009 Mar-Apr; 25(2):134-5OP

Abstract

PURPOSE

To report a method of rectangular 3-snip punctoplasty (2 vertical cuts at either side of the vertical canaliculus and 1 cut at the base). Outcomes are compared with the more conventional and anatomically destructive 3-snip triangular punctoplasty (1 cut at the vertical canaliculus, 1 cut at the horizontal canaliculus, and 1 cut at the base).

METHODS

Retrospective review of all eyes undergoing 3-snip punctoplasty between January 1, 2003 and January 8, 2005.

RESULTS

Seventy-five patients were eligible for this study. One hundred eight eyes with patent punctum and lacrimal systems prior to surgery underwent punctoplasty (49 rectangular and 59 triangular punctoplasty). Follow-up of 8 days to 2.3 years (mean, 0.68 years). Ages ranged between 16.8 and 99.8 years (mean, 69.5 years). Forty-five patients (60%) were women. There was a trend for patients to be symptomatic postoperatively despite patent punctum and lacrimal systems following triangular (10 of 59, 16.9%) than those who underwent rectangular punctoplasty (5 of 49, 10.2%) although this difference was not significant (difference in proportions = 0.05; CI: -17.635 to 17.645; p = 0.99).

CONCLUSIONS

This study showed that there were more failures in eyes with triangular punctoplasty. Previous studies have shown that the punctae and canaliculi are important in normal lacrimal drainage. Rectangular punctoplasty is a simple, safe, and quick procedure that maintains the normal anatomy and physiology of the canalicular system, while maintaining a patent punctum and should be considered as a less destructive alternative to the traditional triangular punctoplasty.

Authors+Show Affiliations

Oxford Eye Hospital, West Wing, John Radcliffe Hospital, Headley Way, Headington, Oxford, UK. melchak@hotmail.comNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19300158

Citation

Chak, Melanie, and Fiona Irvine. "Rectangular 3-snip Punctoplasty Outcomes: Preservation of the Lacrimal Pump in Punctoplasty Surgery." Ophthalmic Plastic and Reconstructive Surgery, vol. 25, no. 2, 2009, pp. 134-5.
Chak M, Irvine F. Rectangular 3-snip punctoplasty outcomes: preservation of the lacrimal pump in punctoplasty surgery. Ophthalmic Plast Reconstr Surg. 2009;25(2):134-5.
Chak, M., & Irvine, F. (2009). Rectangular 3-snip punctoplasty outcomes: preservation of the lacrimal pump in punctoplasty surgery. Ophthalmic Plastic and Reconstructive Surgery, 25(2), pp. 134-5. doi:10.1097/IOP.0b013e3181994062.
Chak M, Irvine F. Rectangular 3-snip Punctoplasty Outcomes: Preservation of the Lacrimal Pump in Punctoplasty Surgery. Ophthalmic Plast Reconstr Surg. 2009;25(2):134-5. PubMed PMID: 19300158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rectangular 3-snip punctoplasty outcomes: preservation of the lacrimal pump in punctoplasty surgery. AU - Chak,Melanie, AU - Irvine,Fiona, PY - 2009/3/21/entrez PY - 2009/3/21/pubmed PY - 2009/6/17/medline SP - 134 EP - 5 JF - Ophthalmic plastic and reconstructive surgery JO - Ophthalmic Plast Reconstr Surg VL - 25 IS - 2 N2 - PURPOSE: To report a method of rectangular 3-snip punctoplasty (2 vertical cuts at either side of the vertical canaliculus and 1 cut at the base). Outcomes are compared with the more conventional and anatomically destructive 3-snip triangular punctoplasty (1 cut at the vertical canaliculus, 1 cut at the horizontal canaliculus, and 1 cut at the base). METHODS: Retrospective review of all eyes undergoing 3-snip punctoplasty between January 1, 2003 and January 8, 2005. RESULTS: Seventy-five patients were eligible for this study. One hundred eight eyes with patent punctum and lacrimal systems prior to surgery underwent punctoplasty (49 rectangular and 59 triangular punctoplasty). Follow-up of 8 days to 2.3 years (mean, 0.68 years). Ages ranged between 16.8 and 99.8 years (mean, 69.5 years). Forty-five patients (60%) were women. There was a trend for patients to be symptomatic postoperatively despite patent punctum and lacrimal systems following triangular (10 of 59, 16.9%) than those who underwent rectangular punctoplasty (5 of 49, 10.2%) although this difference was not significant (difference in proportions = 0.05; CI: -17.635 to 17.645; p = 0.99). CONCLUSIONS: This study showed that there were more failures in eyes with triangular punctoplasty. Previous studies have shown that the punctae and canaliculi are important in normal lacrimal drainage. Rectangular punctoplasty is a simple, safe, and quick procedure that maintains the normal anatomy and physiology of the canalicular system, while maintaining a patent punctum and should be considered as a less destructive alternative to the traditional triangular punctoplasty. SN - 1537-2677 UR - https://www.unboundmedicine.com/medline/citation/19300158/Rectangular_3_snip_punctoplasty_outcomes:_preservation_of_the_lacrimal_pump_in_punctoplasty_surgery_ L2 - http://dx.doi.org/10.1097/IOP.0b013e3181994062 DB - PRIME DP - Unbound Medicine ER -