Comparison of preoperative and postoperative results of “canalicular triangular flap” and “triangular three-snip” punctoplasty techniques in patients with punctum stenosis using anterior segment optical coherence tomography

Purpose: To compare the results and success rates of patients with epiphora due to punctal stenosis operated with the “canalicular triangular flap punctoplasty” and the “triangular three -snip punctoplasty” using anterior segment optical coherence tomography (AS-OCT). Methods: This study is a retrospective cohort analysis of patients who were diagnosed with punctal stenosis and underwent canalicular triangular flap or triangular three-snip punctoplasty between September 2021 and June 2022. Results: The study included 80 eyes of 43 patients consisting of 15 males and 28 females. Forty eyes underwent canalicular triangular flap punctoplasty (Group A) and 40 eyes underwent triangular three-snip punctoplasty (Group B) technique. The mean age of the patients was 63.9 ± 10.9 years (37–88 years). In Group A, the anatomic success was 100% and functional success was 95% at 6 months.In Group B, 77.5% functional success and 75% anatomic success were achieved at 6 months. Conclusions: The canalicular triangular flap technique was more successful in providing punctal patency both anatomically and functionally than the triangular three-snip punctoplasty. AS-OCT is a method that provides objective, quantitative results in the diagnosis and follow-up of punctal stenosis and may be used more widely in punctum and vertical canaliculi pathologies.