title: Histopathologic changes in punctal stenosis.
abstract: OBJECTIVE
  To describe the pathologic changes in punctal stenosis by reporting the histopathologic findings in a series of punctoplasty specimens.
  
  
  METHODS
  Observational retrospective chart review. Electronic health records of all patients having punctoplasty over a 2-year period at an academic oculoplastic practice were examined. All patients whose records included pathology reports were entered into a database.
  
  
  RESULTS
  Twenty-four patients, representing 30 eyes, had pathology records in the electronic health records. Patients were 75% women and had an average age of 65 (19-88) years. Associated conditions included blepharitis (71%), dry eye syndrome, or Meibomian gland dysfunction (63%). Histopathologic examination demonstrated chronic inflammation in 11 eyes (36.7%), fibrosis in 7 eyes (23.3%), chronic inflammation and fibrosis in 4 eyes (13.3%), squamous metaplasia in 3 eyes (10%), normal conjunctival mucosa in 3 eyes (10%), and Actinomyces israelii canaliculitis in 2 eyes (6.7%).
  
  
  CONCLUSIONS
  Nearly all histopathologic specimens revealed findings consistent with inflammation, fibrosis, or both. These findings provide evidence to support the hypothesis that the many etiologic causes of punctal stenosis are linked by a common pathophysiologic mechanism involving inflammation.
authors.affiliation: Weill Cornell Medical College, New York, New York, USA.
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Port
authors.forename: Yao-Tseng
authors.initials: YT
authors.lastname: Chen
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Lelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001762:Blepharitis / Q000150:complications / Q000175:diagnosis*; D003608:Dacryocystorhinostomy; D015352:Dry Eye Syndromes / Q000150:complications / Q000175:diagnosis*; D057286:Electronic Health Records; D005141:Eyelid Diseases / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005355:Fibrosis; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000209:etiology / Q000473:pathology*; D008297:Male; D008537:Meibomian Glands / Q000473:pathology*; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000473:pathology; D012189:Retrospective Studies; D055815:Young Adult