Three Different Modalities for Treatment of Inflammatory Punctal Stenosis

Tanta University

Status: Completed

Conditions: Treatment; Modalities; Inflammatory Punctal Stenosis

Treatments: Drug: Triamcinolone acetonide; Drug: Punctal dilation and topical medication; Procedure: Punctal dilation

Study type: Interventional

Funder types: Other

Identifiers

NCT06798025

36264MS245/2/23

Details and patient eligibility

About

This study aimed to compare the efficacy of three various modalities of treatment of inflammatory punctal stenosis (Punctal dilatation alone, combined punctal dilatation with topical medications, or peri-punctal injection of Triamcinolone acetonide)

Full description

Acquired punctal stenosis is a condition in which the external opening of the lacrimal canaliculus, located in the nasal part of the palpebral margin, is narrowed or occluded. This condition results from chronic inflammation of the external punctum, leading to gradual fibrotic changes in the ostium, followed by progressive occlusion of the duct.

Different modalities were described for the treatment of acquired punctual stenosis. Repeated dilatation of the stenotic punctum is a simple procedure that may provide temporary improvement of the symptoms, but restenosis is common unless additional procedures are performed. Many other methods were used to augment punctual size, including 1-snip, 2-snip, and 3-snip punctoplasty, supplemented with adding sutures or Mini-Monoka insertion and punch punctoplasty.

Enrollment: 60 patients

Sex: All

Ages: 33 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age from 33 to 75.
• Both sexes.
• Patients with inflammatory punctal stenosis or occlusion complaining of symptomatic epiphora.

Exclusion criteria

• Subjects with previous lacrimal surgeries.
• Subjects with lid margin malposition such as ectropion, entropion, or lid retraction.
• Subjects with medial lid masses obscuring the punctum.
• Subjects with a history of ocular trauma involving the medial aspect of the lid margin.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 3 patient groups

Group A

Experimental group

Description:

Patients were treated with punctal dilatation only

Treatment:

Procedure: Punctal dilation

Group B

Experimental group

Description:

Patients were treated with a combination of punctual dilation and topical medication in the form of preservative-free steroid eye drops based on dexamethasone sodium phosphate (0.1%) and preservative-free artificial tears based on sodium hyaluronate, polyethylene, and propylene Glycol.

Treatment:

Drug: Punctal dilation and topical medication

Group C

Experimental group

Description:

Patients were treated with a peri-punctual injection of Triamcinolone acetonide.

Treatment:

Drug: Triamcinolone acetonide