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Kuroda K, Toshida H, Sorita Y, Ichikawa K, Matsuzaki Y, Ohta T. Surgical Punctal Occlusion; Combined Lacrimal Canaliculi Cauterization and Punctal Suturing for Severe Dry Eye. JOVR [Internet]. 2023Apr.19 [cited 2024May2];18(2):143–149. Available from: https://knepublishing.com/index.php/JOVR/article/view/13179

https://doi.org/10.18502/jovr.v18i2.13179

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authors

  • Kohei Kuroda

    Kohei Kuroda

    Department of Ophthalmology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
  • Hiroshi Toshida

    Hiroshi Toshida

    Department of Ophthalmology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
  • Yoko Sorita

    Yoko Sorita

    Department of Ophthalmology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
  • Kohei Ichikawa

    Kohei Ichikawa

    Department of Ophthalmology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
  • Yusuke Matsuzaki

    Yusuke Matsuzaki

    Department of Ophthalmology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
  • Toshihiko Ohta

    Toshihiko Ohta

    Department of Ophthalmology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan

Published Date

  • Apr 19, 2023
This journal is publishing all the articles under Creative Commons Attribution License CC BY 4.0.

Surgical Punctal Occlusion; Combined Lacrimal Canaliculi Cauterization and Punctal Suturing for Severe Dry Eye

Journal of Ophthalmic and Vision Research (JOVR) / April–June 2023, Volume 18, Issue 2 / Pages 143–149

Abstract

Purpose: To evaluate the treatment outcome of surgical punctal occlusion with combined canaliculi ablation and punctal suturing in patients with severe dry eye.


Methods: Eleven eyes of seven patients were diagnosed with severe dry eye with decreased lacrimal secretion and were refractory to treatment with various eye drops and/or had repeatedly experienced loss of punctal plugs, and continued to experience subjective symptoms received surgical punctal occlusion. In 20 puncta, lacrimal canaliculi ablation was performed along the entire length of the lacrimal canaliculus where a diathermy needle could be inserted. After resection of the annulus fibrosus in the peri-punctal area, tight cross-stitch suturing of the puncta was performed with 8-0 absorbent thread. Visual acuity, corneal staining score according to the area (A) and density (D) classification, and Schirmer tear test (STT); tear break up time (tBUT); and subjective symptoms assessed by the University of North Carolina (UNC) and Dry Eye Management Scale were compared before and one year after surgery.


Results: Recanalization occurred in 1/20 puncta (5.0% at month 5) in 1/11 eyes. Student’s t-test showed significant improvement at one year compared with preoperative values for LogMAR value (P = 0.019), corneal staining score A (P = 0.00003) and D (P = 0.0003), STT (P = 0.004), and subjective symptoms (P = 0.015). No change was shown in tBUT and no serious adverse event occurred.


Conclusion: This improved, minimally invasive surgical procedure has a low recanalization rate and achieves both objective and subjective improvements at one year.


Keywords: Cauterization; Dry Eye; Lacrimal Canaliculi; Lacrimal Puncta; Punctal Occlusion

Keywords:

Cauterization, Dry Eye, Lacrimal Canaliculi, Lacrimal Puncta, Punctal Occlusion

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