The effect of 4-snip punctoplasty evaluated by tear meniscus height using Fourier-domain optical coherence tomography

1. Sung-eun Kim¹
2. Chang-yeom Kim¹
3. Jin-sook Yoon¹
4. Sae-heun Rho²
5. Sang-yeul Lee¹

¹Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
²Dong‐A University College of Medicine, Pusan, Korea

Purpose: To report the effect of 4-snip punctoplasty by measurement of tear meniscus height and assess the correlation with epiphora symptom score or satisfaction score of the patient

Methods: Prospective study of all eyes of punctal stenosis and patent lacrimal system treated with 4-snip punctoplasty, operated by a single surgeon. Before and 4-weeks after the procedure, tear meniscus heights were measured using Fourier-domain optical coherence tomography. Punctum size, epiphora symptom score, and subjective symptom score were also evaluated.

Results & Conclusons: Twenty-nine eyes of 19 patients were treated with 4-snip punctoplasty and the effect was evaluated after 4-weeks. Mean tear meniscus height before punctoplasty was 452.4um and significantly decreased after the procedure to 341.6um (p<0.001). Mean epiphora symptom score also showed significant decrease from 3.76 to 1.62 (p<0.001). Seventy-eight percent of the patients were satisfied after the procedure. Tear meniscus height after the procedure showed significant correlation with epiphora symptom score and patient's satisfaction. In conclusion, 4-snip punctoplasty is an effective and satisfactory procedure for punctal stenosis.