Surgical management of lacrimal punctal cauterization in chronic GVHD-related dry eye with recurrent punctal plug extrusion

被引：0
作者：
S Yaguchi
Y Ogawa
M Kamoi
M Uchino
Y Tatematsu
Y Ban
E Ohba
S Okamoto
E Goto
K Tsubota
机构：
[1] Keio University School of Medicine,Department of Ophthalmology
[2] School of Dental Medicine,Department of Ophthalmology
[3] Tsurumi University,Department of Medicine, Division of Haematology
[4] Keio University School of Medicine,undefined
来源：
Bone Marrow Transplantation | 2012年 / 47卷
关键词：
dry eye; chronic GVHD; surgical punctal occlusion; cauterization;
D O I：
暂无
中图分类号：
学科分类号：
摘要：
We investigated the efficacy of lacrimal punctal occlusion surgery with a cautery device in patients with chronic GVHD (cGVHD)-related dry eye, with recanalization of puncta and recurrent punctal plug extrusion. A total of 23 puncta from 14 eyes of 10 patients with chronic GVHD (cGVHD)-related dry eye underwent punctual thermal cauterization with a high-temperature disposable cautery device. All patients were refractory to conventional treatment, including artificial tear eye drops, autologous serum eye drops and vitamin A eye drops, and had a history of recanalization and recurrent punctal plug extrusion. The effect of lacrimal punctal cauterization by thermal cautery device was evaluated by changes in subjective symptom scores, corrected distance visual acuity, Schirmer's test values, fluorescein staining scores, rose bengal staining scores, and tear-film break-up time before and 3 months after the surgery. Subjective symptom scores, Schirmer's test values, fluorescein and rose bengal scores, and tear-film break-up time improved significantly 3 months after the surgery. Recanalization of puncta was not observed in all the cases (0 of 14 eyes, 0%). Lacrimal punctal cauterization was effective with no recanalization and significant improvements in subjective symptoms and the ocular surface environment in cGVHD-related dry eye patients who had been refractory to conventional treatments.
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页码：1465 / 1469
页数：4
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  • [1] Franklin RM(1983)Ocular manifestations of graft-vs-host disease Ophthalmology 90 4-13
  • [2] Kenyon KR(2006)Ancillary therapy and supportive care of chronic graft-versus-host disease: National Institutes of Health Consensus Development Project on criteria for clinical trials in chronic graft-versus-host disease: V. Ancillary Therapy and Supportive Care Working Group Report Biol Blood Marrow Transplant 12 375-396
  • [3] Tutschka PJ(1999)Dry eye after haematopoietic stem cell transplantation Br J Ophthalmol 83 1125-1130
  • [4] Saral R(2003)Autologous serum eye drops for the treatment of severe dry eye in patients with chronic graft-versus-host disease Bone Marrow Transplant 31 579-583
  • [5] Green WR(2008)Ocular surface and tear functions after topical cyclosporine treatment in dry eye patients with chronic graft-versus-host disease Bone Marrow Transplant 41 293-302
  • [6] Santos GW(2010)Topical tranilast for treatment of the early stage of mild dry eye associated with chronic GVHD Bone Marrow Transplant 45 565-569
  • [7] Couriel D(2012)Punctal occlusion is safe and efficient for the treatment of keratoconjunctivitis Sicca in patients with ocular GvHD Bone Marrow Transplant 47 981-984
  • [8] Carpenter PA(2004)Punctal occlusion in the management of chronic Stevens-Johnson syndrome Ophthalmology 111 895-900
  • [9] Cutler C(2011)Surgical punctal occlusion with a high heat-energy-releasing cautery device for severe dry eye with recurrent punctal plug extrusion Am J Ophthalmol 151 483-487
  • [10] Bolaños-Meade J(2005)The effect of autologous serum eyedrops in the treatment of severe dry eye disease: a prospective randomized case-control study Am J Ophthalmol 139 242-246
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