title: Stenotic puncta: microsurgical punctoplasty.
abstract: The successful long-term management of epiphora caused by punctal stenosis presents a difficult problem for the ophthalmologist. The purpose of this paper is to describe a successful procedure that respects lacrimal excretory anatomy and provides excellent results in the management of epiphora. Twenty-three patients (32 eyes) with punctal stenosis underwent excision of the stenotic puncta followed by microscopic externalization of the vertical canaliculus. At 6 months and 1 year, only one patient complained of tearing; at 2 years, three eyes experienced tearing and were successfully dilated; no eyes experienced tearing at 4 years. Only one patient experienced a dry eye, which was managed with topical lubricants. Microscopic punctoplasty thus provides excellent long-term management of epiphora from punctal stenosis with minimal disruption of anatomy.
authors.affiliation: Department of Ophthalmology, University of Kentucky, Lexington.
authors.forename: W N
authors.initials: WN
authors.lastname: Offutt
authors.forename: D E
authors.initials: DE
authors.lastname: Cowen
mesh_terms: D000368:Aged; D003608:Dacryocystorhinostomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000209:etiology; D007767:Lacrimal Duct Obstruction / Q000150:complications; D008297:Male; D008866:Microsurgery / Q000379:methods; D009301:Nasolacrimal Duct / Q000601:surgery; D011379:Prognosis; D011677:Punctures / Q000379:methods