Lacrimal punctal occlusion with conjunctival flap

Abstract

Purpose: To describe a technique of punctal occlusion with conjunctival flap and present its surgical results in a group of patients.Methods: The records of 30 patients who underwent punctal occlusion with a conjunctival flap due to dry eye were reviewed. A medial segment of the eyelid margin, including the punctum, was superficially excised. The canalicular opening was closed with suturing, and then the margin defect was covered with a conjunctival transposition flap.Results: Sixty-nine puncti (41 lower and 28 upper puncti) in 52 eyes were occluded with a conjunctival flap. During the follow-up period (mean, 4.8 months; range, 2-13 months), 65 puncti (94%) remained occluded and 4 puncti reopened. Because of postoperative epiphora, the procedure was surgically reversed in 2 lower puncti. No complication was encountered during or after surgery.Conclusion: Conjunctival transposition flap may be an alternative surgical method for effective and reversible occlusion of the lacrimal punctum in eyes with severe dry eye.