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Title Feasibility study to investigate the perforated punctal plug as an alternative to three snip punctoplasty for the treatment of acquired punctal stenosis (POPPY) – A progress report
Submitted by Mohammad Dehabadi
Abstract Number 349
Review Result poster presentation
Purpose To determine if perforated punctal plugs (PPPs) are an acceptable alternative to 3-snip punctoplasty (3SP) in the treatment of acquired punctal stenosis (APS).
Methods Randomised study recruiting 60 patients with APS at the Western Eye Hospital, London.

Patients are assessed by a masked investigator using the Watery Eye Qualify of Life Questionnaire (WEQOL), slit lamp examination, lacrimal syringing, and OCT measurement of puncta. Eligible patients are randomised to receive a 3SP or PPP, with PPP removal at 2 months.

Patients are reviewed at 6 months post 3SP or PPP removal using the same criteria as baseline. Final review at 12 months is by telephone to complete the WEQOL.

Primary outcome measure:
– Estimated number of times eye has watered in the past week
Secondary outcome measures:
– Effect of watering on quality of life
– Punctum size
– Tear meniscus
– OCT measurements

Results 36 patients have been recruited to date, with 6-month data on 14 patients, and 12-month data on 11 patients. 1 patient withdrew due to failure, 1 lost to follow-up at 6 months, and 2 lost to follow up at 12 months.

The mean age of patients is 62 years (range 27-85) and 78% are female. At baseline, patients are dabbing their eyes on average 96 times in the preceding week (95% CI 73-115), with the mode punctum size being Kashkouli grade 2, and mode tear meniscus height of 0.3mm (range 0.5mm) in the symptomatic eye.

Conclusion We present an update on recruitment and the baseline characteristics of this clinical trial. We report no adverse events thus far and hope to conclude recruitment within 12 months.

Additional Authors

Last name Initials City / Hospital Department
Hoffman JJ Western Eye Hospital Ophthalmology
Yang E Moorfields Eye Hospital Ophthalmology
A’Hern R London
Alnahrawy A Western Eye Hospital Oculoplastics
Fayers T Western Eye Hospital Oculoplastics

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