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Surgical punctal occlusion with a high heat-energy releasing cautery device for severe dry eye with recurrent punctal plug extrusion.
Am J Ophthalmol 2011; 151(3):483-7.e1AJ

Abstract

PURPOSE

To report the rate of recanalization and the efficacy of punctal occlusion surgery with a high heat-energy-releasing cautery device in patients with severe dry eye disease and recurrent punctal plug extrusion.

DESIGN

Prospective, interventional case series.

METHODS

Seventy puncta from 44 eyes of 28 dry eye patients underwent punctal occlusion with thermal cautery. All patients had a history of recurrent punctal plug extrusion. A high heat-energy-releasing thermal cautery device (Optemp II V; Alcon Japan) was used for punctal occlusion surgery. Symptom scores, best-corrected visual acuity, fluorescein staining score, rose bengal staining score, tear film break-up time, and Schirmer test values were compared before and 3 months after the surgery. Rate of punctal recanalization also was examined.

RESULTS

Three months after surgical cauterization, symptom score decreased from 3.9 ± 0.23 to 0.56 ± 0.84 (P < .0001). Logarithm of the minimal angle of resolution best-corrected visual acuity improved from 0.11 ± 0.30 to 0.013 ± 0.22 (P = .003). Fluorescein staining score, rose bengal staining score, tear film break-up time, and the Schirmer test value also improved significantly after the surgery. Only 1 of 70 puncta recanalized after thermal cauterization (1.4%).

CONCLUSIONS

Punctal occlusion with the high heat-energy-releasing cautery device not only was associated with a low recanalization rate, but also with improvements in ocular surface wetness and better visual acuity.

Authors+Show Affiliations

Department of Ophthalmology, School of Dental Medicine, Tsurumi University, Yokohama, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21232733

Citation

Ohba, Emii, et al. "Surgical Punctal Occlusion With a High Heat-energy Releasing Cautery Device for Severe Dry Eye With Recurrent Punctal Plug Extrusion." American Journal of Ophthalmology, vol. 151, no. 3, 2011, pp. 483-7.e1.
Ohba E, Dogru M, Hosaka E, et al. Surgical punctal occlusion with a high heat-energy releasing cautery device for severe dry eye with recurrent punctal plug extrusion. Am J Ophthalmol. 2011;151(3):483-7.e1.
Ohba, E., Dogru, M., Hosaka, E., Yamazaki, A., Asaga, R., Tatematsu, Y., ... Goto, E. (2011). Surgical punctal occlusion with a high heat-energy releasing cautery device for severe dry eye with recurrent punctal plug extrusion. American Journal of Ophthalmology, 151(3), pp. 483-7.e1. doi:10.1016/j.ajo.2010.08.045.
Ohba E, et al. Surgical Punctal Occlusion With a High Heat-energy Releasing Cautery Device for Severe Dry Eye With Recurrent Punctal Plug Extrusion. Am J Ophthalmol. 2011;151(3):483-7.e1. PubMed PMID: 21232733.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical punctal occlusion with a high heat-energy releasing cautery device for severe dry eye with recurrent punctal plug extrusion. AU - Ohba,Emii, AU - Dogru,Murat, AU - Hosaka,Eri, AU - Yamazaki,Asako, AU - Asaga,Rie, AU - Tatematsu,Yukako, AU - Ogawa,Yoko, AU - Tsubota,Kazuo, AU - Goto,Eiki, Y1 - 2011/01/12/ PY - 2010/04/28/received PY - 2010/08/31/revised PY - 2010/08/31/accepted PY - 2011/1/15/entrez PY - 2011/1/15/pubmed PY - 2011/4/9/medline SP - 483 EP - 7.e1 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 151 IS - 3 N2 - PURPOSE: To report the rate of recanalization and the efficacy of punctal occlusion surgery with a high heat-energy-releasing cautery device in patients with severe dry eye disease and recurrent punctal plug extrusion. DESIGN: Prospective, interventional case series. METHODS: Seventy puncta from 44 eyes of 28 dry eye patients underwent punctal occlusion with thermal cautery. All patients had a history of recurrent punctal plug extrusion. A high heat-energy-releasing thermal cautery device (Optemp II V; Alcon Japan) was used for punctal occlusion surgery. Symptom scores, best-corrected visual acuity, fluorescein staining score, rose bengal staining score, tear film break-up time, and Schirmer test values were compared before and 3 months after the surgery. Rate of punctal recanalization also was examined. RESULTS: Three months after surgical cauterization, symptom score decreased from 3.9 ± 0.23 to 0.56 ± 0.84 (P < .0001). Logarithm of the minimal angle of resolution best-corrected visual acuity improved from 0.11 ± 0.30 to 0.013 ± 0.22 (P = .003). Fluorescein staining score, rose bengal staining score, tear film break-up time, and the Schirmer test value also improved significantly after the surgery. Only 1 of 70 puncta recanalized after thermal cauterization (1.4%). CONCLUSIONS: Punctal occlusion with the high heat-energy-releasing cautery device not only was associated with a low recanalization rate, but also with improvements in ocular surface wetness and better visual acuity. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/21232733/Surgical_punctal_occlusion_with_a_high_heat_energy_releasing_cautery_device_for_severe_dry_eye_with_recurrent_punctal_plug_extrusion_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(10)00688-4 DB - PRIME DP - Unbound Medicine ER -