Outcome of modified rectangular 3-snip punctoplasty with mini-Monoka stent and mitomycin-C

Abstract

Purpose The aim of this study was to evaluate the efficacy of combining mitomycin-C (MMC) with modified rectangular 3-snip punctoplasty and mini-Monoka stent to treat punctal stenosis. Design This is a prospective interventional case series. Patients and methods The study included 62 eyes of 31 patients diagnosed with epiphora secondary to punctal stenosis who received modified rectangular 3-snip punctoplasty with mini-Monoka stent and MMC in their right eyes (Rt eye group) and modified rectangular 3-snip punctoplasty with mini-Monoka stent only in their left eyes (Lt eye group). Epiphora, punctal opening, and tear meniscus height (TMH) were evaluated and compared with the preoperative data in both groups. The main outcome measures were epiphora, punctal opening, and TMH. Results A total of 17 (54.8%) patients were females, with a mean age of 58.4±5.1 years. No surgical complications were reported. Epiphora and TMH were improved, with a functional success of 90.3% in the Rt eye group and 87.1% in the Lt eye group, as compared with the preoperative status (P<0.001). The punctum remained open, with anatomical success achieved in 29 (93.5%) eyes in the Rt eye group and in 28 (90.3%) eyes in the Lt eye group (P<0.03). Moreover, the TMH and punctal grading were significantly better in the Rt eye group compared with Lt eye group during the 12th and 24th postoperative week follow-up visits (P<0.05). Conclusion MMC proved to be an efficient and safe therapeutic adjuvant in the armamentarium of oculoplastic surgeons to treat punctal stenosis.

Keywords

• mitomycin-c
• punctal stenosis
• punctal stent
• punctoplasty