Surgical Results of Punctoplasty Using Thermal Vaporization in Patients with Punctual Stenosis

Purpose: To evaluate the surgical results of punctoplasty using thermal vaporization in patients with punctual stenosis. Methods: We retrospectively reviewed the charts of 84 patients who underwent punctoplasty using thermal vaporization via a radiofrequency surgical unit (Ellman surgitron (R); Ellman International Inc., Oceanside, NY, USA) from 2012 to 2015. The final surgical results included the success rates, postoperative complications, and punctual size and shape. Results: A total of 123 eyes and 219 puncta of 84 patients were included in this study. The average age was 53.5 years with a mean follow-up period of 32.2 months. Before surgery, the mean punctum diameter was 0.24 mm. After surgery, the mean punctum diameter was 2.59 mm. At last follow-up, 207 puncta (95%) were found to be patent, while 9 puncta (4%) became stenotic again. The anatomic success rate was 95%. During fluorescein dye disappearance tests after surgery, 3 eyes (2.4%) were grade 3, 5 eyes (4%) were grade 2, 3 eyes (2.4%) were grade 1, and 112 eyes (91%) were grade 0. If grades 1 or 0 were defined as functional success, then the functional success rate was 115/123 eyes (93.5%). After punctoplasty, 110 eyes (89.4%) showed no signs of epiphora. However, 5 eyes (4.1%) showed intermittent epiphora and 8 eyes (6.5%) showed persistent epiphora. According to a survey study on tearing, the functional success rate was 115/123 eyes (93.4%). Conclusions: After punctoplasty using thermal vaporization, high anatomic and functional success rates were achieved, with the two success rates being almost identical. No significant complications were reported postoperatively.