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Gary Lelli, Alexander Port, Yao-Tseng Chen; Histopathologic changes in punctal stenosis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6030.
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To describe the pathologic changes in punctal stenosis by reporting the histopathologic findings in a series of punctoplasty specimens.
Observational retrospective chart review. Electronic health records of all patients having punctoplasty over a two-year period at an academic oculoplastic practice were examined. All patients whose records included pathology reports were entered into a database.
24 patients, representing 30 eyes, had pathology records in the EHR. Patients were 75% female, and had an average age of 65 (19-88). 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 Acintomyces Israelii canaliculitis in 2 eyes (6.7%).
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.
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