punctal plasty

Puncture angioplasty is effective, simple operation, less postoperative complications, and repeatable treatment. It is one of the effective methods for treating punctum abnormalities. Treatment of diseases: dacryocystitis Indication Puncture forming is applicable to: 1. Punctal occlusion or membrane closure. 2. Punctal stenosis, ineffective after expansion therapy. 3. The tip of the lacrimal canal is blocked. 4. The lesion involves the punctum or the tip of the lacrimal canal (such as pigmented nevus). Although it does not cause obstruction, it needs surgical resection. Contraindications 1. There is inflammation in the skin of the gingival margin and internal iliac crest. 2. The conjunctiva has acute inflammation. Preoperative preparation Rinse the conjunctival sac with saline. Surgical procedure 1. Bititeectomy Surgery is best performed under a surgical microscope. (1) Expand the punctum with a punctum dilator. If the punctum has been occluded, under the operating microscope or magnifying glass, after the accurate position is found, the physiological saline is injected to confirm that the lacrimal passage is smooth, and then the operation is continued. (2) If the tip of the lacrimal canal is obstructed, after the punctum is enlarged, the obstruction is probed with a small lacrimal probe (No. 00 or No. 0), and saline is injected to confirm that the lacrimal passage is smooth, and then the operation is continued. . If the blockage is solid and the exploration is difficult, it is not necessary to reluctantly. After the occipital margin of the iliac crest including the obstruction of the lacrimal canal is opened, the lacrimal passage is checked and the operation is continued. (3) The tear duct is cut away from the punctum by about 2 mm along the posterior lip of the gingival margin; if the tip of the lacrimal canal is blocked, the length of the cut should be 1 to 2 mm above the obstruction. (4) Using a bite cutter to cut the conjunctival surface of the lacrimal canal, close to the occlusion of the punctum, and cut a small round defect. If the tip of the lacrimal canal is obstructed, a small round defect is cut in the conjunctival section of the distal end of the proximal end of the intubate tubule. In this way, the newly formed punctum is immersed in the tear lake or in contact with the eyeball. 2. Scissor tectomy Surgery is best performed under a surgical microscope. (1) Expand the punctum with a punctum dilator. If it has been occluded, it will pass through the surgical microscope or magnifying glass, and then pass through the physiological saline to confirm that the lacrimal passage is smooth, and then continue the operation. (2) Pull down the lower jaw and use a small pointed straight shear to extend vertically into the punctum and cut the vertical part of the canaliculus. (3) Using a small pointed straight or blunt tear tube knife, cut or cut the canal small tube horizontally along the posterior lip of the temporal margin, the incision is 2~3mm long; if the first end of the lacrimal canal is blocked, the incision is performed. Should pass the obstruction 1 to 2 mm. (4) Use a small toothed file to lift the angle between the two cut openings, use a small pointed straight cut to close the end of the two cuts, cut off a triangular tissue, and press to stop bleeding. (5) Place a thin plastic tube or rubber drainage strip on the canaliculus, so that one end is exposed outside the incision and fixed to prevent the newly formed punctum from occluding. Apply antibiotic eye ointment to the conjunctival sac and cover the eye pad.