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CA Cardona, M Tejeda, B Dominguez, H Lopez; Comparison Of Two Punctoplasty Tec . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3020.
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Purpose:To compare two punctoplasty techniques evaluating the effectiveness and the incidence of relapse. Methods:We included patients with stenosis or epithelialization of lacrimal points, with symptoms such as ephipora, any age, without previous trauma, dry eye or anomalous palpebral position. Two techniques were done; technique 1 consisted on cutting a square around the obstructed point and a partial resection of the vertical portion of the lacrimal canaliculus. Technique 2 consisted of two wedge cuts at the level of the lacrimal point. In both techniques permeability of the lacrimal system was proven by irrigation. Follow up was on day 15, 30 and 60 after surgery and absence of ephipora was considered a surgical success. Results:Twenty six lacrimal points of eight female patients with ephipora and an average age of 64 years old were operated. Fifteen with technique 1 and eleven with technique 2. On day 15, ninety percent of the lacrimal points were permeable with technique 1 and 80 % with technique 2. On day 30, forty five percent of the lacrimal points were permeable with technique 1 and 65 % with technique 2. On day 60, forty percent were permeable with technique 1 and 60 % with technique 2. After 60 days of follow up, 3 patients continued with ephipora with technique 1 and 1 patient with technique 2. Conclusion:The obstruction of the lacrimal points is more frequent in women. Both techniques had relapses mainly with technique 1. The wedge cut (technique 2) is more effective in the postoperative evolution.
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