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The International Journal on Orbital Disorders, Oculoplastic and Lacrimal Surgery
Volume 43, 2024 - Issue 2
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Research article

Topical cyclosporin A 0.05% eye drops for management of symptomatic acquired punctal stenosis: a prospective, controlled clinical study

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Pages 190-195 | Received 16 Mar 2023, Accepted 25 Jun 2023, Published online: 18 Jul 2023
 

ABSTRACT

Purpose

To study the efficacy of cyclosporin 0.05% eye drops in the management of grade 1 and 2 acquired punctal stenosis and to compare the results with the clinical outcomes of mini-Monoka insertion.

Methods

A prospective, controlled, interventional clinical study includes all patients (16 years and older) with symptomatic epiphora and diagnosed with grade 1 or grade 2 acquired punctal stenosis. All patients undergo punctal dilatation, canalicular probing, and nasolacrimal duct irrigation. Afterwards, patients are divided into two groups: Group A: patients receive only medical treatment in the form of topical 0.05% cyclosporin (Restasis®, Allergan Inc.) twice daily for 6 months. Group B: patients receive mini-Monoka stent insertion in the lower canaliculus for 6 weeks. Outcome measures are changes in Munk scoring, grading of the punctum, and functional and anatomical success. Functional success is defined as Munk score 0 to 1 and FDDT grade 0–2. Anatomical success is defined as grade 3 punctum.

Results

Forty-two patients are included in the study, with 21 patients in each group. There were no significant differences in the Munk score between the two groups before treatment; however, group B had a significantly higher mean rank at 6 months after treatment. After treatment, the punctal size was significantly larger in group B at 4 weeks and 3 months. However, no significant difference in punctal size was detected at 6 months after treatment between the two groups.

Conclusion

Application of cyclosporin 0.05% eye drops is a simple and efficient non-interventional method in the management of grade 1 and 2 acquired punctal stenosis.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.

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