An OCT Study of Lower Lacrimal Punctal Stenosis

Abstract Purpose To assess the lower lacrimal measurements in stenosis versus non- stenosed punctiusing spectral domain anterior segment optical coherence tomography. Patients and Methods The study included 39 puncti of 21 healthy asymptomatic volunteers attending the general and oculoplastic outpatient clinics (Group I : Control group) and 30 puncti of 17 subjects with a clinical diagnosis of punctal stenosis defined as the punctal diameter less than 0.3 mm measured by slit-lamp biomicroscopy (Group II : Cases group). The punctal diameter was measured by slit-lamp biomicroscopy in all subjects. The external punctal diameter, the inner punctal diameter at 500 µm, the punctal depth and tear meniscus height were measured using anterior segment optical coherence tomography. Results The internal punctal diameter at 500µ (74.92 µm ± 60.99 vs 24.07 µm ± 34.30) showed statistically significant lower measurements in the stenosis group compared to the control group. No statistically significant differences were between the 2 groups otherwise: external punctal diameter (571.44 µm ± 148.78 vs 545.23 µm ± 201.72), punctal depth (824.49 µm ± 354.14 vs 707.63 µm ± 552.80),. (and tear meniscus height (356.19 µm ± 166.83 vs 403.57 µm ± 244.24 Conclusion : Anterior segment optical coherence tomography provides a superior ability to assess the patency of the proximal lacrimal drainage system over the regular routine slit lamp examination. This is probably useful in diagnosis of cases of epiphora with externally non-stenosed puncti and distally patent passages.