Abstract
Literature on lacrimal punctal tumors is limited due to their rarity. Our aim in this study was to evaluate the clinicopathological characteristics of these tumors and assess functional and aesthetic outcomes after CO2 laser ablation with silicone stent intubation. A retrospective consecutive study was conducted from December 2013 to November 2020. All patients who received CO2 laser ablation with silicone intubation for their punctal tumors at National Cheng Kung University Hospital, a tertiary hospital in Taiwan, were included in this study. Demographic and clinical information was gathered during preoperative and follow-up visits. Thirty-three Han Chinese patients with a solitary punctal tumor were included in this study. Demographically, we found a female predominance (75.8%), and most tumors were located at the lower punctum (69.7%). The incidence of melanocytic nevus was higher in punctal tumors (78.8%) than in benign eyelid tumors (22.3%). Irrigation tests were performed in the 33 patients during follow-up visits, all of whom exhibited patency of the lacrimal system. No patient complained of epiphora after surgery. Thirty-two patients (97%) were satisfied with the aesthetic outcome after surgery. Superpulse CO2 laser ablation followed by silicone stent intubation is a safe and effective treatment for benign punctal tumors. In addition, compared to those of eyelid tumors, the clinicopathological characteristics of lacrimal punctal tumors are different, and melanocytic nevus was the main cause of these tumors.
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National Cheng Kung University Hospital provided funding for the fee of proofreading (English Language Assistance), but had no role in the design or conduct of this research.
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CC: designed study plan and wrote paper; YKL: editing; CCL: designed study plan and editing.
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This research was partially funded by National Cheng Kung University Hospital, Tainan, grant number NCKUH-11009013. The funding organization had no role in the design or conduct of this research. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.
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In adherence with the Tenets of the Declaration of Helsinki, the study was approved by the Institutional Review Board of the National Cheng Kung University Hospital.
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10103_2021_3500_MOESM1_ESM.tif
Supplementary Figure 1. Preoperative and postoperative photographs before the silicone stent removal; First row, a 69-year-old male presenting with a peripunctal tumor over his right lower punctum preoperatively (1a); a close-up view when flipping his eyelid inside out preoperatively (1b); postoperative photograph with the Autostable Bicanaliculus Intubation Set II in place (1c). Second row, a 53-year-old female presenting with a peripunctal tumor over her left upper punctum preoperatively (1d); a close-up view when flipping her eyelid inside out preoperatively (1e); postoperative photograph with the Masterka stent in place (1f). (TIF 7520 KB)
10103_2021_3500_MOESM2_ESM.tif
Supplementary Figure 2. Preoperative and postoperative photographs of four patients with peripunctal tumors; First row, a 68-year-old male presenting with a peripunctal tumor encircling his left upper punctum (2a); three months after surgery, his affected eye (2b) was symmetric with the fellow eye (2c). Second row, a 54-year-old female presenting with an enlarging peripunctal tumor over her right lower punctum (2d); one month after surgery, there was only a slight swelling noted when comparing the affected eye (2e) with the other eye (2f). Third row, a 31-year-old female presenting with a peripunctal tumor encircling her right lower punctum (2g); five years after surgery, it is difficult to decipher which eye was the affected eye (2h and 2i). Fourth row, a 41-year-old male presenting with a peripunctal tumor swelling his right lower punctum (2j); two months after surgery, his affected eye (2k) was symmetric with the fellow eye (2l). (TIF 48997 KB)
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Chen, C., Lee, YK. & Lai, CC. Outcomes of lacrimal punctal tumors treated with a superpulse CO2 laser. Lasers Med Sci 37, 2287–2291 (2022). https://doi.org/10.1007/s10103-021-03500-0
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DOI: https://doi.org/10.1007/s10103-021-03500-0