Zastosowanie zatyczek perforowanych w leczeniu nabytego zwężenia zewnętrznych punktów łzowych
Perforated Punctal Plugs for the Management of Acquired External Punctal Stenosis
Radosław Różycki, Dominika Białas, Marek Rękas, Izabela Nowak-Gospodarowicz, Aleksandra Jakubaszek
Klinika Okulistyczna Wojskowego Instytutu Medycznego w Warszawie
Kierownik: dr hab. n. med. Marek Rękas, prof. nadzw. WIM
Summary: The aim of this study is to present perforated punctal plugs insertion as a method of treatment in patients with acquired external punctal stenosis.
Materials and Methods: Consecutive patients suffered from epiphora caused by acquired punctal stenosis were qualified. 30 patients, 24 women and 6 men were treated. The age range was 32 to 78 years (mean 56.9 ± 11.04 years).
Fluorescein dye disappearance test and subjective assessment of epiphora in 10 point scale were evaluated by each patient preoperatively and at the end of follow-up to estimate severity of epiphora and effectiveness of applied method of treatment.
Punctal plugs insertions were performed in outpatient clinic. The plugs were extracted after 3 months by each patient.
Wilcoxon test and Spearman rang correlation test were used for statistical analysis.
Results: Our results confirmed improvement in functional signs and subjective improvement on the epiphora scale in most patient. Mean DDT test results decreased statistically significant from 3.5 ± 0.5 before to 1.3 ± 1.2 after treatment (p = 0.000004). Epiphora grade dropped from 9 points (Me) to 3 (Me) 3 months after surgery. Only in one case (3.3%) applied treatment method turned out to be ineffective.
Conclusions: Punctal plug insertion is the method of choice of treatment for patients suffering from epiphora caused by aquired external punctal obstruction. In that patients external punctal intubation allows to increase functional parameters and relieve patients from subjective symptoms. Assessment of the lower lid laxity is crucial in qualification of the patient for this kind of treatment, because it may influence the effectiveness of this method.
Słowa kluczowe: patologiczne łzawienie, stenoza punktu łzowego, perforowane zatyczki punktów łzowych.
Keywords: epiphora, punctal stenosis, lacrimal punctum plugs.