Chang Minwook, Ahn Soh-Eun, Baek Sehyun
From the *Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea; †Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea; and ‡Department of Ophthalmology, Guro Hospital, Korea University College of Medicine, Seoul, Korea.
J Craniofac Surg. 2013 Sep;24(5):1628-30. doi: 10.1097/SCS.0b013e318292c68b.
The objectives of this study were to report the success rates for perforated punctual plug (PPP) in the management of acquired punctual stenosis and to evaluate the factors influencing success rates.
This was a retrospective, cross-sectional, comparative study.
There were 20 patients.
Twenty eyes of 20 patients who underwent PPP implantation for the management of acquired punctual stenosis and punctual obstruction were retrospectively evaluated regarding sex and age of the patients and the duration and severity of epiphora, associated blepharitis, and the success of treatment. In all patients, punctum dilation was performed carefully to prevent damage to the ampulla before the insertion of plugs. Perforated punctual plugs were removed 2 months after insertion.
There were 7 cases of punctal stenosis, 9 cases of membranous obstruction, 2 punctal burns, 1 papilloma, and 1 nevus involving the punctum causing epiphora. The mean age of patients was 41.4 (SD, 3.9) years. The mean interval between the onset of epiphora and PPP implantation was 32.1 (SD, 10.7) months. Associated chronic blepharitis was detected in 13 eyes. Success was achieved in 17 eyes (85%). Patients whose procedures failed were older (67.7 vs 36.8, P = 0.019) and more likely to have blepharitis (100: 23.5%, P = 0.031). Spontaneous plug loss was noted in 4 eyes between the 1- and 2-month follow-up examination. No patients had residual epiphora.
Perforated punctual plug implantation for the treatment of acquired punctual stenosis and obstruction is very effective. However, careful punctum dilation should be performed, and the patient age and comorbidities should be considered before treatment.
本研究的目的是报告穿孔泪点塞（PPP）治疗后天性泪点狭窄的成功率，并评估影响成功率的因素。
这是一项回顾性横断面比较研究。
共20例患者。
对20例因后天性泪点狭窄和泪点阻塞接受PPP植入术的患者的20只眼睛进行回顾性评估，内容包括患者的性别、年龄、溢泪的持续时间和严重程度、相关睑缘炎以及治疗效果。所有患者在插入泪点塞之前均仔细进行泪点扩张以防止壶腹受损。穿孔泪点塞在插入后2个月取出。
有7例泪点狭窄、9例膜性阻塞、2例泪点烧伤、1例乳头状瘤和1例累及泪点的痣导致溢泪。患者的平均年龄为41.4（标准差，3.9）岁。溢泪发作与PPP植入之间的平均间隔为32.1（标准差，10.7）个月。13只眼睛检测到相关慢性睑缘炎。17只眼睛（85%）治疗成功。手术失败的患者年龄较大（67.7岁对36.8岁，P = 0.019），且更易患睑缘炎（100%对23.5%，P = 0.031）。在1至2个月的随访检查之间，4只眼睛出现泪点塞自发脱落。没有患者有残留溢泪。
穿孔泪点塞植入术治疗后天性泪点狭窄和阻塞非常有效。然而，应仔细进行泪点扩张，并且在治疗前应考虑患者年龄和合并症。
