Management of Bi-Punctal Stenosis by One-Snip Punctoplasty Combined with Silicone Intubation

Purpose: Assessment of the efficacy of upper and lower one-snip punctoplasty combined with silicone tube stenting for the management of bi-punctal stenosis. Methods: Prospective interventional case series of 20 patients (33 eyes, 66 puncta) with epiphora due to bi-punctal stenosis. All the patients were subjected to bi-punctal 1-snip punctoplasty with silicone intubation, and the tube was kept for 3 months. The follow-up was extended for 6 months after tube removal. The resolution of epiphora with patent puncta was considered as a complete functional success, while patent puncta with residual epiphora were considered as an anatomical success. Results: The mean patients' age was 41.3 years and 55% were females. Grade 0 puncta were found in 9.1%, and grade 1 represented 39.4%, while 51.5% had grade 2 puncta. Silicone tube was removed after an average period of 12.1 +/- 2.7 weeks. Complete functional success was reported in 90.9% while anatomical success was noticed in 97%. Conclusion: One-snip punctoplasty combined with 3 months of silicone intubation can be considered in the management of bi-punctal stenosis achieving high success rates with a minor discrepancy between functional and anatomical outcomes.