Resolution of recalcitrant chronic papillary conjunctivitis associated with epiphora following punctoplasty and lacrimal stenting

摘要

ObjectiveTo assess the use of lacrimal stenting for chronic papillary conjunctivitis associated with epiphora in young adults with little or no atopic background. MethodsA retrospective interventional case series of 21 consecutive patients (36 eyes) treated for epiphora and chronic papillary conjunctivitis at a tertiary university-affiliated medical center between January 2014 and August 2015 by the same oculoplastic surgeon (I.A). Data were collected by retrospective file review. Patients with a history of ocular disease were excluded from the study. Treatment modalities included lacrimal stenting, punctoplasty, and conservative topical medication. The main outcome measure was post-treatment presence of epiphora and conjunctivitis. ResultsMean patient age was 40 ± 11 years; 86% of patients were female. Fifteen (72%) had bilateral disease. Mean follow-up time was 3.9 ± 1.7 months. Delayed tear clearance as well as a patent lacrimal apparatus were noted in all eyes. No apparent cause of the symptoms was found in any of the eyes. In 12 of the 13 patients (92%) who underwent tube or stent placement, the conjunctivitis and epiphora resolved. In the remainder, symptoms resolved bilaterally in only 1 of 4 patients (25%) who underwent punctoplasty and in only 1 of 4 patients (25%) treated conservatively. ConclusionRecalcitrant papillary conjunctivitis improves following nasolacrimal stenting. Further studies are needed using a prospective controlled design and longer follow-up time.