Abstract
Purpose: To evaluate the use of bicanalicular silicone intubation for the management of punctal stenosis and obstruction in patients with allergic conjunctivitis. Methods: A retrospective interventional case series of patients with acquired epiphora due to stenotic or obstructed puncta as a result of allergic conjunctivitis was performed. Punctal dilation and bicanalicular silicone intubation were performed in all patients. Munk Scale for grading of epiphora along with grading of fluorescein dye disappearance test was used to evaluate the functional improvement. Grading of punctal stenosis using Kashkouli's grading system was applied to evaluate the anatomical improvement. Patients having canalicular or nasolacrimal duct obstruction, punctal stenosis, and obstruction due to other causes were excluded. Results: Fifty-one patients met the inclusion criteria with male-female ratio of 1:1.55 and an average age of 46 years at presentation. High patient tolerances without complications with the use of tubes were reported. Significant improvement 6 months after tube removal in comparison to preoperative period was found with anatomical and functional success rate of 91.83% and 87.75%, respectively. Two patients had a recurrence of the punctal stenosis many months after stent removal because of the early tube prolapse and exacerbation of the allergic conjunctivitis. Conclusions: Bicanalicular silicone intubation seems to be a well-tolerated and effective tool in the management of acquired punctal stenosis or obstruction secondary to allergic conjunctivitis. Bicanalicular silicone intubation appears to be a good option as patients with allergic conjunctivitis typically present with bilateral involvement of both puncti.