A histopathological study of lacrimal puncta in patients with primary punctal stenosis.

Autor: Jang JK; Department of Ophthalmology, CHA Bundang Medical Center, College of Medicine, CHA University, #59 Yatap-ro, Bundang-gu, Seongnam, 13496, Republic of Korea., Lee SM; Department of Ophthalmology, CHA Bundang Medical Center, College of Medicine, CHA University, #59 Yatap-ro, Bundang-gu, Seongnam, 13496, Republic of Korea., Lew H; Department of Ophthalmology, CHA Bundang Medical Center, College of Medicine, CHA University, #59 Yatap-ro, Bundang-gu, Seongnam, 13496, Republic of Korea. eye@cha.ac.kr.
Jazyk: angličtina
Zdroj: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2020 Jan; Vol. 258 (1), pp. 201-207. Date of Electronic Publication: 2019 Nov 12.
DOI: 10.1007/s00417-019-04514-9
Abstrakt: Purpose: We investigated the etiology of punctal stenosis based on the histopathological features of puncta and clinical correlations in punctal stenosis patients.
Methods: A retrospective review was conducted of 69 cases from 38 patients who were diagnosed with punctal stenosis. Slit-lamp examination, the lacrimal irrigation test, dacryocystography, and spectral domain-optical coherence tomography were performed for the evaluation of punctal occlusions. For treatment, punctoplasty using a punch biopsy with or without silicone tube insertion and histopathological examinations were performed.
Results: The pathological features of the punctal membranes were classified into two types of epithelia: squamous (95.7%, 66/69) and columnar (4.3%, 3/69). The squamous epithelial specimens were divided into three groups: fibrous tissue (66.8%, 48/69), goblet cells (21.8%, 48/69), and keratinization (4.3%, 3/69). Most of the subepithelial pathology was fibrosis (82.6%, 57/69), and inflammation was noted in 17.4% (12/69) of the patients. Subepithelial fibrosis was the most common pathological feature in patients exhibiting stenosis with a squamous epithelium, while inflammation was more strongly correlated with patients with a columnar epithelium. However, there was no correlation between the histopathological findings and treatment outcomes.
Conclusion: Our histopathological findings suggest that primary fibrosis of the stenotic punctum was caused by intrinsic inflammation of the puncta rather than spreading from the conjunctiva or eyelid. Punctoplasty was effective in treating punctal stenosis, regardless of the epithelial type.
Databáze: MEDLINE
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