Three Different Modalities for Treatment of Inflammatory Punctal Stenosis

Tanta University60 enrolled

Overview

This study aimed to compare the efficacy of three various modalities of treatment of inflammatory punctal stenosis (Punctal dilatation alone, combined punctal dilatation with topical medications, or peri-punctal injection of Triamcinolone acetonide)

Acquired punctal stenosis is a condition in which the external opening of the lacrimal canaliculus, located in the nasal part of the palpebral margin, is narrowed or occluded. This condition results from chronic inflammation of the external punctum, leading to gradual fibrotic changes in the ostium, followed by progressive occlusion of the duct. Different modalities were described for the treatment of acquired punctual stenosis. Repeated dilatation of the stenotic punctum is a simple procedure that may provide temporary improvement of the symptoms, but restenosis is common unless additional procedures are performed. Many other methods were used to augment punctual size, including 1-snip, 2-snip, and 3-snip punctoplasty, supplemented with adding sutures or Mini-Monoka insertion and punch punctoplasty.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Modalities Treatment Inflammatory Punctal Stenosis

Interventions

Punctal dilationPROCEDURE

Patients were treated with punctal dilatation only.

Punctal dilation and topical medicationDRUG

Patients were treated with a combination of punctal dilation and topical medication in the form of preservative-free steroid eye drops based on dexamethasone sodium phosphate (0.1%) and preservative-free artificial tears based on sodium hyaluronate, polyethylene, and propylene Glycol.

Triamcinolone acetonideDRUG

Patients were treated with a peri-punctual injection of Triamcinolone acetonide.

Eligibility

Sex: ALLMin age: 33 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age from 33 to 75. * Both sexes. * Patients with inflammatory punctal stenosis or occlusion complaining of symptomatic epiphora. Exclusion Criteria: * Subjects with previous lacrimal surgeries. * Subjects with lid margin malposition such as ectropion, entropion, or lid retraction. * Subjects with medial lid masses obscuring the punctum. * Subjects with a history of ocular trauma involving the medial aspect of the lid margin.

Locations (1)

Tanta University

Tanta, El-Gharbia, Egypt

Outcomes

Primary Outcomes

Degree of patient satisfaction

The degree of patient satisfaction was assessed using 3-point Likert Scale (1=Not satisfied, 2: No Difference, 3:Satisfied)

Time frame: 3 months postoperatively

Secondary Outcomes

Punctal diameter

The punctal diameter of cases was measured before and after 1 month and 3 months of treatment.

Time frame: 3 months postoperatively

Data from ClinicalTrials.gov

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