Comparison Of Outcomes Of Preservative-Free Dexamethasone Eye Drops And 3-Snip Punctoplasty In Management Of Acquired Punctal Stenosis

Authors

1 Ophthalmology, National Eye Center, Rod El Farag, Cairo, Egypt

2 Ophthalmology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

Abstract

Background: Acquired punctal stenosis causes epiphora, and there are many ways to manage it. Aim of the work: To contrast non-preserved dexamethasone eye drops' application against 3-snip punctoplasty in treating punctual occlusion. Patients and Methods: This prospective, comparative, interventional study involved 50 stenotic puncta at El-Hussein University Hospital and Rod El-Farag National Eye Centre. Group A (25) received preservative-free Monodexin 0.01% prepared eye drops, and Group B (25) underwent 3-snip autoplasty. One day, one week, one, three, and six months later, they were re-evaluated ophthalmologically. Results: The mean age was 49.64±11.18 years; the studied patients were 7 males and 43 females. punctal opening started in group A at one month (68%) versus 100% postoperatively in group B. Restenosis occurred in group B after 1 and 3 months; contrarily, restenosis was not recorded in group A throughout the study. One month after treatment, epiphora grading and fluorescein dye disappearance test results were better in the autoplasty group but incomparable (p-value = 0.173, 0.265). Satisfaction after 6 months was less in group A (68% vs 80%). Conclusion: 3-snip punctoplasty showed better epiphora relief and more satisfaction in patients, but restenosis occurred in contrast to the stable outcome of non-preserved dexamethasone, which can be used as an alternative first line of treatment of acquired external punctual stenosis rather than the traditional surgical 3-snip approach.

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