Mini stent a viable alternative treatment for punctal, canalicular stenosis

Mini stent punctocanaliculoplasty proved to be a safe and effective alternative to dacryocystorhinostomy in managing epiphora secondary to punctal and canalicular stenosis, a study found.

The Mini-Monoka monocanalicular stent (FCI Ophthalmics) fits into the punctum and ampula without suturing. It is indicated primarily for canalicular lacerations.

“The insertion of Mini-Monoka stents is quick, relatively painless, noninvasive and generally without significant risk to the patient,” the study authors said. “The rationale is to widen the punctum and canaliculus and place a stent to prevent subsequent narrowing, similar to angioplasty elsewhere. The procedure is undertaken under topical anaesthesia, eliminating any need for general anesthesia, and there is no risk of bleeding.”

The retrospective study included 123 eyes of 77 patients; 73% of eyes had punctal stenosis, 72% had canalicular stenosis and 46% had a combination of both. Patients were evaluated 6 weeks after stent insertion, and stents were removed in a clinical environment; three stents fell out prematurely.

Study results showed that 101 eyes (82%) had markedly improved symptoms and required no further treatment.

Excluding cases with concomitant structural pathologies contributing to epiphora symptoms such as demonstrable lid laxity, nasolacrimal duct stenosis, lymphoma and caruncular enlargement, the success rate improved to 88%.

Twenty-two eyes showed little or no improvement in symptoms. These cases involved concurrent lid laxity, distal lacrimal system stenosis requiring dacryocystorhinostomy, caruncular enlargement, lacrimal sac lymphoma and dislocated stents, the authors said.

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Source:

Br J Ophthalmol. 2012;96:671-673.