Infrared, OCT help predict patients who will benefit from punctoplasty
Optical coherence tomography (OCT) and infrared imaging of the lacrimal punctum may help identify patients who are more likely to benefit symptomatically from punctoplasty, according to a study. In addition, patients with smaller puncta have greater symptomatic improvement.
“However, the results suggest that inner punctum diameter (not readily measurable by slit-lamp examination), rather than the surface diameter, is correlated with outcome,” researchers said. “Additionally, OCT measurements of the tear meniscus height within the punctum may be related to the degree of epiphora.”
A case-control study was conducted involving 20 patients with epiphora who were listed for punctoplasty and 20 healthy controls to determine the application of imaging the stenotic lacrimal punctum with infrared photographs and OCT, as well as to identify characteristics of the lacrimal punctum in patients who benefit from punctoplasty.
Using the Munk score, researchers asked the patients listed for punctoplasty to rate their epiphora before and after punctoplasty. The patients also had preoperative OCT and infrared imaging of the affected punctum. They were divided into two groups (those with improvement in epiphora and those without) and were then compared with 20 healthy controls.
There were significantly smaller infrared image measurement in patients whose epiphora improved compared with those whose did not in both the area of the punctal aperture and in the maximum punctal diameter.
In addition, patients whose epiphora improved had a significantly smaller preoperative punctal diameter at 100 μm depth on OCT compared with healthy controls; this was not seen in those with no improvement in epiphora.
No significant difference existed in the punctum diameter among the three groups at the punctum surface entrance or at 500 μm depth. Compared with healthy controls, patients with epiphora had a higher tear meniscus within the punctum.