The Impact of Proximal Nasolacrimal Abnormalities on the Surgical Outcomes of Punctal Stenosis.
Punctoplasty failure was more common in patients aged 60 and older.
The Impact of Proximal Nasolacrimal Abnormalities on the Surgical Outcomes of Punctal Stenosis.
This study evaluates the frequency and nature of proximal canalicular pathologies in patients with severe punctal stenosis (Grade 0 or 1) undergoing snip punctoplasty without stent or plug implantation and explores their relationship with surgical success.
With systemic diseases, prior lacrimal surgeries, or nasolacrimal duct obstructions beyond the common were excluded.
in patients 60 or older, punctal surgery failed to fix tearing more often
Surgical success was achieved in 396 eyes (76.74%).
Failure occurred in 120 eyes (23.26%), with proximal canalicular stenosis being the most common associated pathology (38.33%), followed by mid-canalicular (26.67%) obstructions.
Since we exclusively included patients with Grade 0-1 punctal stenosis, the relatively lower functional success observed in our cohort may reflect a higher underlying prevalence of canalicular pathology in this subgroup.
Gender was not a significant factor.
Although anatomical patency can be achieved with snip punctoplasty, functional success is often compromised by unrecognized canalicular abnormalities-particularly in patients with severe punctal stenosis.
Chronic ocular inflammation and fibrosis may affect both the punctum and canalicular pathway. Adjunctive use of Mini-Monoka stents should be considered to address deeper canalicular disease.
Future prospective studies with standardized symptom scores and extended follow-up are warranted.