الفهرس 
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Abstract
Acquired external punctal stenosis (AEPS) is a common
disorder accounting for 8% of all cases of epiphora in a tertiary care
practice. Many local and systemic diseases such as cicatricial
conjunctival diseases, chemical burns, herpetic viral infection, toxic
effects of topical or systemic medications, various infections, eyelid
malposition, aggressive lacrimal probing, or different forms of trauma,
tumors and aging changes have been linked to the development of
acquired external punctal stenosis (AEPS).
There are several modalities used for the management of
acquired external punctal stenosis such as punctal dilatation, 1-snip
punctoplasty, 2-snip punctoplasty, triangular 3-snip punctoplasty,
rectangular 3-snip punctoplasty, 4-snip punctoplasty, punctal punching
with Kelly’s or Riess punch, punctoplasty with mitomycin-C, and
inserting perforated punctal plugs, bicanalicular self-retaining stents,
or mini-monoka.
The aim of this study was to evaluate and compare the
outcomes of minimally invasive (bicanalicular self retaining stent)
versus invasive (rectangular 3 snip punctoplasty) treatment modalities
used in treatment of acquired lower punctal stenosis.
This was a prospective randomized comparative study that was
carried out on 39pt (65 eyes) having acquired lower punctal stenosis
grade 1 or grade 2 represented to outpatient clinic of Menofia
University Hospital from November 2019 to February 2021.
Bilaterality was noted in 66.67% (26/39) of the patients. Epiphora was
the most common presenting complaint noted in 100% (65/65) of
eyes.
The patients were divided into 2 groups:
group A was treated by inserting bicanalicular self retaining
stent under sedation.
There were 20 patients (34 eyes); 13 males (65%) and 7
females (35%).Mean age of patients was 54.75±6.84. Punctal stenosis
was unilateral in 6 patients (30%) and bilateral in 14 patients (70%).
Punctal stenosis was grade 1 in 10 eyes (29.4%) and grade 2 in 24
eyes (70.6%).
group B was treated by rectangular 3 snip punctoplasty under
topical anaesthesia.
There were 19 patients (31 eyes); 9 males (47.4%) and 10
females (52.6%).Mean age of patients was 55.26±7.01.Punctal stenosis
was unilateral in 7 patients (36.8%) and bilateral in 12 patients
(63.2%). Punctal stenosis was grade 1 in 9 eyes (29.0%) and grade
2 in 22 eyes (71.0%).