J Korean Ophthalmol Soc.  2012 Sep;53(9):1219-1225. 10.3341/jkos.2012.53.9.1219.

The Effect of Punctoplasty with Pigtail Probe for Canalicular Intubation in Patients with Punctal Obstruction

Affiliations
  • 1Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea. eyerheu@hanafos.com

Abstract

PURPOSE
To assess the surgical results of a punctoplasty with insertion of a silicone tube using a pigtail probe for the management of acquired punctal obstruction.
METHODS
The medical records of 61 patients who underwent an operation for the management of punctual obstruction were reviewed. After punctal dilation, fluorescein dye disappearance test was performed to evaluate its efficacy. In the case of no functional delay after punctal dilation, three-snip punctoplasty with a silicone tube using a pigtail probe was performed. In the case of a functional delay, three-snip punctoplasty with a silicone tube into the nasolacrimal duct was performed.
RESULTS
The surgical success over 1 year was 39.1% in patients who underwent only three-snip punctoplasty, 79.2% in patients who underwent a three-snip punctoplasty with a silicone tube insertion into the nasolacrimal duct, and 85.7% in patients who underwent a three-snip punctoplasty with canalicular intubation using a pigtail probe.
CONCLUSIONS
The use of a pigtail probe for canalicular intubation together with a three-snip punctoplasty is useful to prevent the recurrence of punctal obstruction.

Keyword

Epiphora; Pigtail probe; Punctal obstruction; Punctoplasty; Silicone tube insertion

MeSH Terms

Fluorescein
Humans
Intubation
Lacrimal Apparatus Diseases
Medical Records
Nasolacrimal Duct
Recurrence
Silicones
Fluorescein
Silicones

Figure

  • Figure 1 (A) A vertical snip incision is made on the medial aspect of the posterior rim of the puctum. (B) Pigtail probe is passed along the canaliculus and exits at the opposite puctum. (C) 6-0 prolene stitch is threaded onto the probe which is then reversed leaving a 6-0 prolene stitch in the system. (D) Silicone tube is threaded over a 6-0 prolene stitch. (E) The 6-0 prolene suture is tied and the silicone tubing is rotated so the knot site is at the level of the common canaliculus. (F) Silicone tubing with a 6-0 prolene stitches inside it in the medial canthus.


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