الفهرس 
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Abstract
This study aimed to compare between three snip punctoplasty and lacrimal stenting procedures for the treatment of punctal stenosis or occlusion.
This study was carried out during the period from October 2016 to April 2018. All surgeries were performed at Sohag University Hospital. The surgeries were performed by one surgeon.
Fifty eyes of thirty patients with punctal occlusion were included in this study. The patients were divided randomly into two groups, each included 25 eyes. In the first group (group A) , the patients had lacrimal stenting procedure , Perforated plug insertion was done in 13 eyes (group A1) and Lacrimal closed intubation was done in 12 eyes (groupA2). The second group (group B) , the patients had three snip punctoplasty.
All patients were subjected to preoperative evaluation including history taking ; data collected included age, sex, main symptoms, onset of tearing, history of any topical or systemic medications and history of any surgeries. Then ophthalmological evaluation was done including : Best corrected visual acuity, slit lamp examination to detect any associated ocular pathology and determine the degree of punctal occlusion. Then syringing and probing to exclude any associated lacrimal pathway obstruction.
Postoperative follow up included history taking as regard recurrence of epiphora and the degree of satisfaction.slit lamp examination was done to assess the punctum.
Results revealed that both three snip punctoplasty and Lacrimal stenting are effective procedures in treatment of punctal stenosis or occlusion. Lacrimal stenting was associated with higher anatomical and functional success.
Functional success as regard cessation of epiphora and patient satisfaction was statistically significant (p value < .05 ) between both groups.
Our results suggest that closed intubation is effective method for treatment of punctal stenosis especially severe cases. And Perforated punctal plugs are easy , rapid and effective procedure with less complications than other procedures.
Conclusion:
Our results confirm that Lacrimal stenting ( both closed intubation and perforated plug insertion) is an effective method for treatment of punctal occlusion. Although the difference in the size of the punctum was statistically insignificant but the difference in patient degree of satisfaction was statistically significant.