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| Name | Canalicular triangular flap punctoplasty : A NOVEL TECHNIQUE for managing punctal stenosis |
| Video Uploader | Video From Eyeplasty with Mohammad Idris |
| Upload Date | This Video Uploaded At 06-12-2024 16:57:24 |
| Video Discription | If the punctum would not admit the 26g lacrimal cannula without prior dilatation, it is classified as stenosed. The indication for punctoplasty is a patient with both epiphora and a stenosed punctum, patent to syringing once the punctum is dilated. Surgical methods Step 1. After instillation of a topical anesthetic drop (proparacaine, 0.5%), the conjunctiva below the punctum is infiltrated with 2% lignocaine. The punctum is dilated and syringing was performed to exclude any horizontal or common canalicular agenesis or obstruction. The triangular three‑snip punctoplasty procedure - making 2‑mm vertical incision through the posterior wall of the punctum and vertical canaliculus, followed by a horizontal incision along 2 mm of the horizontal canaliculus. Finally, a diagonal incision is made to connect the beginning of the vertical incision with the end of the horizontal incision. Canalicular triangular flap punctoplasty, a 3‑mm horizontal incision is made through the punctum opening. Subsequently, scissors are brought to an upright position, and a 2‑mm vertical incision is made from the posterior ampulla to create a triangular shape. Unlike the other technique, the hypotenuse of the triangle is preserved and gently everted toward the globe with fine forceps. The triangular flap is dissected vertically to create two vertical lamellae of lacrimal mucosa and conjunctiva. The separated conjunctiva is excised. The triangular mucosal flap of the canaliculus is preserved and everted outward, and is then sutured to the conjunctiva at the apex of the triangle using 8-Vicryl as demonstrated in the study by Taskiran Comez et al. ===== In geometry, the hypotenuse is the longest side of a right triangle and is opposite the right angle: The canalicular triangular flap technique the canalicular mucosal flap is preserved, and the continuity of the lacrimal mucosa with conjunctiva is provided, which utilizes appropriate re-epithelization of the wound edges, resulting in a wide punctal opening for the upper lacrimal system in the long term. |
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