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Outcomes of 4-snip punctoplasty for severe punctal stenosis: measurement of tear meniscus height by optical coherence tomography.
Am J Ophthalmol 2012; 153(4):769-73, 773.e1-2AJ

Abstract

PURPOSE

To investigate the surgical outcome of rectangular 4-snip punctoplasty, a modification of rectangular 3-snip procedures, using objective measurements.

DESIGN

Noncomparative case series.

METHODS

The medical charts of patients who underwent rectangular 4-snip punctoplasty for severe punctal stenosis with at least 6 months follow-up were reviewed. Before surgery and at 1 and 6 months after surgery, subjective evaluation of tearing was assessed using Munk scores. The size of the punctum was graded based on slit-lamp examination, and measurement of tear meniscus height was done using Fourier-domain optical coherence tomography.

RESULTS

A total of 45 eyes (26 patients) were studied. The subjective epiphora score was significantly reduced after surgery and maintained until 6 months after the surgery (χ2 for trend test, P<.001). The grade of the punctum size was also significantly enlarged after surgery and the enlarged punctum was maintained until 6 months after the surgery (χ2 for trend test, P<.001). The mean preoperative tear height (452.4±249.3 μm) was significantly reduced both at 1 month after surgery (341.6±207.9 μm; P=.003, paired t test) and at 6 months after surgery (362.1±212.6 μm; P=.004, paired t test). The functional success rate was 93.3% and anatomic success rate was 88.9% at 6 months after surgery.

CONCLUSIONS

Rectangular 4-snip punctoplasty was an anatomically and functionally effective procedure for severe punctal stenosis patients, maintaining large puncta for fairly long periods.

Authors+Show Affiliations

Department of Ophthalmology, Myongji Hospital, Kwandong University College of Medicine, Koyang, Korea.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22264691

Citation

Kim, Sung Eun, et al. "Outcomes of 4-snip Punctoplasty for Severe Punctal Stenosis: Measurement of Tear Meniscus Height By Optical Coherence Tomography." American Journal of Ophthalmology, vol. 153, no. 4, 2012, pp. 769-73, 773.e1-2.
Kim SE, Lee SJ, Lee SY, et al. Outcomes of 4-snip punctoplasty for severe punctal stenosis: measurement of tear meniscus height by optical coherence tomography. Am J Ophthalmol. 2012;153(4):769-73, 773.e1-2.
Kim, S. E., Lee, S. J., Lee, S. Y., & Yoon, J. S. (2012). Outcomes of 4-snip punctoplasty for severe punctal stenosis: measurement of tear meniscus height by optical coherence tomography. American Journal of Ophthalmology, 153(4), pp. 769-73, 773.e1-2. doi:10.1016/j.ajo.2011.09.026.
Kim SE, et al. Outcomes of 4-snip Punctoplasty for Severe Punctal Stenosis: Measurement of Tear Meniscus Height By Optical Coherence Tomography. Am J Ophthalmol. 2012;153(4):769-73, 773.e1-2. PubMed PMID: 22264691.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of 4-snip punctoplasty for severe punctal stenosis: measurement of tear meniscus height by optical coherence tomography. AU - Kim,Sung Eun, AU - Lee,Sung Jun, AU - Lee,Sang Yeul, AU - Yoon,Jin Sook, Y1 - 2012/01/20/ PY - 2011/06/23/received PY - 2011/09/21/revised PY - 2011/09/21/accepted PY - 2012/1/24/entrez PY - 2012/1/24/pubmed PY - 2012/5/10/medline SP - 769-73, 773.e1-2 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 153 IS - 4 N2 - PURPOSE: To investigate the surgical outcome of rectangular 4-snip punctoplasty, a modification of rectangular 3-snip procedures, using objective measurements. DESIGN: Noncomparative case series. METHODS: The medical charts of patients who underwent rectangular 4-snip punctoplasty for severe punctal stenosis with at least 6 months follow-up were reviewed. Before surgery and at 1 and 6 months after surgery, subjective evaluation of tearing was assessed using Munk scores. The size of the punctum was graded based on slit-lamp examination, and measurement of tear meniscus height was done using Fourier-domain optical coherence tomography. RESULTS: A total of 45 eyes (26 patients) were studied. The subjective epiphora score was significantly reduced after surgery and maintained until 6 months after the surgery (χ2 for trend test, P<.001). The grade of the punctum size was also significantly enlarged after surgery and the enlarged punctum was maintained until 6 months after the surgery (χ2 for trend test, P<.001). The mean preoperative tear height (452.4±249.3 μm) was significantly reduced both at 1 month after surgery (341.6±207.9 μm; P=.003, paired t test) and at 6 months after surgery (362.1±212.6 μm; P=.004, paired t test). The functional success rate was 93.3% and anatomic success rate was 88.9% at 6 months after surgery. CONCLUSIONS: Rectangular 4-snip punctoplasty was an anatomically and functionally effective procedure for severe punctal stenosis patients, maintaining large puncta for fairly long periods. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/22264691/Outcomes_of_4_snip_punctoplasty_for_severe_punctal_stenosis:_measurement_of_tear_meniscus_height_by_optical_coherence_tomography_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(11)00767-7 DB - PRIME DP - Unbound Medicine ER -