Puntoplastia en dos cortes modificada en estenosis de puntos y canalículos lagrimales inferiores / Modified two-snip punctoplasty for stenosis of inferior lacrimal points and canaliculi

RESUMEN Objetivo: Determinar los resultados alcanzados con la utilización de la puntoplastia en dos cortes modificada en el manejo de los pacientes con estenosis de los puntos y canalículos lagrimales inferiores. Métodos: Se realizó un estudio descriptivo y retrospectivo de una serie de casos, en el Hospital Universitario Clínico Quirúrgico "Comandante Manuel Fajardo", desde enero del año 2016 a diciembre de 2018. La muestra quedó conformada por 22 pacientes (38 ojos), sometidos a la técnica quirúrgica, y fue caracterizada de acuerdo con la edad, el sexo, el color de la piel, la bilateralidad, la localización anatómica de la obstrucción, los antecedentes patológicos personales, las complicaciones y la evaluación funcional final. Resultados: De un total de 22 pacientes, 17 estuvieron entre las edades de 60 y 79 años, el 72,7 por ciento del sexo femenino y el 86,4 por ciento con piel de color blanco. La blefaritis fue el principal antecedente oftalmológico encontrado (18,2 por ciento), la obstrucción fue bilateral en el 72,7 por ciento de los casos, y fundamentalmente a nivel del punto lagrimal (16 casos). El 86,8 por ciento no mostró complicaciones posoperatorias; 3 casos presentaron extrusión del tutor de silicona, los cuales estuvieron en relación con el fallo en el resultado final. En el 92,1 por ciento se constató el éxito de la cirugía. Conclusiones: La estenosis de la vía lagrimal se produce principalmente en mujeres, de raza blanca, mayores de 60 años y sin antecedentes patológicos referidos. La afectación es más frecuente a nivel del punto lagrimal. Con la técnica quirúrgica se logra un resultado excelente y con complicaciones mínimas(AU)

ABSTRACT Objective: Determine the results achieved by modified two-snip punctoplasty in the management of patients with stenosis of inferior lacrimal points and canaliculi. Methods: A retrospective descriptive study was conducted of a case series at Comandante Manuel Fajardo Clinical Surgical University Hospital from January 2016 to December 2018. The sample was 22 patients (38 eyes) undergoing the surgical technique. The variables studied were age, sex, skin color, bilaterality, anatomical location of the obstruction, personal pathological antecedents, complications and final functional evaluation. Results: Of the total 22 patients, 17 were in the 60-79 years age group, 72.7 percent were female and 86.4 percent were white. Blepharitis was the main ophthalmological antecedent (18.2 percent). Obstruction was bilateral in 72.7 percent of the cases, fundamentally at the lacrimal punctum (16 cases). 86.8 percent did not have any postoperative complication, whereas 3 presented extrusion of the silicone tutor. These were related to failure in the final result. Surgery was successful in 92.1 percent of the cases. Conclusions: Lacrimal duct stenosis prevails in white skin women aged over 60 years without reported pathological antecedents. The disorder is more common at the lacrimal punctum. The surgical technique used achieves excellent results with minimum complications(AU)

An Unusual Case of Double Lacrimal Puncta

PURPOSE: Congenital double puncta are usually unilateral, and the accessory punctum exists on the medial side in a slit configuration that is distinct from the shape of the normal punctum. We report a case of an unusual case of double lacrimal puncta which the lateral, rather than the medial, punctum was judged to be the accessory punctum. CASE SUMMARY: A 39-year-old male patient with no underlying disease and no ophthalmologic history visited our clinic with right eye epiphora of 2 weeks duration. On slit lamp examination, double puncta were observed in the right lower eyelid and the remaining puncta were normal. On lacrimal syringing test and dacryocystography were performed and revealed incomplete obstruction with partial narrowing of the nasolacrimal duct. Silicone tube intubation was performed through the right lower medial punctum and symptoms improved postoperatively. CONCLUSIONS: The present case is an unusual case of double lacrimal puncta which has not been reported in Korea. Unlike the previous literature, the lateral, rather than the medial, punctum was judged to be the accessory punctum. Because accessory punctm can be present on the lateral side, it is necessary to distinguish between the accessory punctm and the main punctum through the accurate dacryocystography and lacrimal syringing test for the treatment of the patient.

A Lacrimal Punctal Keratinizing Cyst of the Lower Lid

PURPOSE: We report an unusual case of a keratinizing cyst on the lacrimal punctum. CASE SUMMARY: A 49-year-old female presented with an outpouching punctal mass at the left lower lid that occurred a week prior to her visit. Histopathological examination revealed a cyst filled with keratin arranged in lamina and surrounding the bacterial colony. The epithelial wall was composed of multilaminar, keratinizing squamous epithelium without goblet cells. The features were consistent with a keratinizing cyst. There was no recurrence at 4 months after the excision, and the punctum was patent. CONCLUSIONS: Keratinizing cyst should be considered as a differential diagnosis of the cystic mass of the punctum. Because it has an excellent prognosis after surgical resection, complete resection should be performed if a keratinizing cyst is suspected.

Successful micro-resection of lacrimal punctum neoplasm using XL -radiofrequency ablation skin apparatus under a microscope / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To study the therapeutic method of XL -radiofrequency ablation skin apparatus (invented by Rehabilitation medicine, PLA General Hospital) in micro-resecting the lacrimal punctum neoplasm and to observe its clinical effects. ·METHODS:XL-radiofrequency ablation skin apparatus was performed on 7 cases (7 eye lesions) of lacrimal punctum neoplasm including 3 intradermal nevus, 1 boundary nevus, 1 mixed nevus with inflammatory granuloma,1 inflammatory granuloma,and 1 squamous papillary cell tumor by separating layer, point and flake removing methods. The clinical effect was investigated 2-6mo postoperatively and leftover was removed by twice. The postoperative follow- up durations ranged from 6 to 60mo. ·RESULTS: Totally 6 cases (6 eye lesions) were cured successfully by once but 1 case by twice. They were all without recurrence, cicatrix, palpebral margin deformity, obstruction of lacrimal punctum, stenosis of lacrimal punctum or epiphora. Micro - resecting the lacrimal punctum neoplasm using the XL-radiofrequency ablation skin apparatus had several advantages, such as high accuracy,no cicatrix,no bleeding,no epiphora,no damage to the structure of lacrimal canaliculus, short operation time, little pain during the procedure, without hospitalization, slight inflammation reaction after procedure. ·CONCLUSION: The efficacy of XL - radiofrequency ablation skin apparatus is significantly more evident and highly accurate in micro - resecting lacrimal punctum neoplasm.

To study the result of the therapeutic effect of Sea buckthorn oil using grab taper lacrimal punctum / Шинэ санаа Шинэ нээлт

Studied with comparing the results of the method of zone which using the Hippophae rhamnoides and normal zone to 22 people who got narrow of lacrimal punctum. In the result of treatment the people’s lacrimal punctum was widen for 64.2% and 64.2% repeated who are zoned normal and the people’s lacrimal punctum was widen for 75% and 12.5% repeated who are zoned with oil of Hippophae rhamnoides after 14-21 days. Here after future, we need to use research the method of using the oil of hippophae hamnoidesfor eyes practice.

Study of lacrimal Punctal Size in Normal Adults

To investigate of lacrimal punctal size in normal korean adults, we measured diameter and area of punctum and punctal papilla according to sex and age group using slit lamp photography in 120 persons, 120 eyes. In upper eyelid, the average diameter and area of lacrimal punctum were 0.57+/-0.2mmxo.29+/-0.1mm, 0.13+/-0.07mm2 andthe average diameter and area of punctal papilla were 1.34+/-0.37mmx0.89+/-0.24mm, 0.98+/-0.53mm2. In lower eyelid, the average diameter and area of lacrimal punctum were 0.61+/-0.17mmx0.3+/-0.1mm, 0.15+/-0.08mm2 and the average diameter and area of punctal papilla were 1.46+/-0.32mmx0.99+/-0.19mm, 1.15+/-0.4mm2. In size difference between lacrimal punctum, lower punctum was larger than upper punctum, but not statistically significant. In size difference between punctal papilla, lower papilla was significantly larger than upper papilla. There is no difference in punctal and papilla size between male and female. The size distribution of punctum was related to age, but size distribution of papilla was not.