Combining Cyclosporine Eye Drops with Punctoplasty Improves Outcomes in Acquired Punctal Stenosis: Study Finds

"At the six-month follow-up, the highest functional success rate was observed in the CsA plus punctoplasty group (88%), compared to 79% with punctoplasty alone and 69% with CsA alone. The combined approach also achieved an anatomical success rate of 90%, indicating its effectiveness in enhancing postoperative recovery and long-term outcomes," the researchers reported in Current Eye Research.

Acquired punctal stenosis is characterized by narrowing the tear drainage openings, leading to chronic epiphora (excessive tearing) and discomfort. Punctoplasty, a minor surgical procedure that enlarges the punctal opening, is a common treatment approach. However, inflammation often contributes to APS, raising interest in anti-inflammatory treatments such as CsA, a topical immunomodulator known for its anti-inflammatory effects in ocular surface diseases.

Against the above background, Melek Mutlu Sönmeza and Elif Ertan Baydemir, the researchers from Turkey, aimed to assess the efficacy of cyclosporine-A 0.05% eye drop in managing acquired punctal stenosis, both as a standalone treatment and in combination with punctoplasty.

For this purpose, the researchers conducted a prospective study on patients with acquired punctal stenosis referred to the oculoplastics clinic. Participants were divided into three groups: Group A received CsA eye drops, Group B underwent punctoplasty, and Group C received both CsA and punctoplasty. The Munk score, fluorescein dye disappearance test (FDDT), and punctal opening grading were assessed at baseline and the 1st and 6th-month follow-ups.

The study led to the following findings:

• The study included 111 eyes from 80 patients.
• At the 1st and 6th-month follow-ups, Group C showed a significantly higher punctum grade than Groups A and B.
• The FDDT grade and Munk scores were significantly lower in Group C, indicating better symptom improvement.
• The functional success rates at the 6th-month follow-up were 69% in Group A, 79% in Group B, and 88% in Group C.
• The anatomical success rates at the 6th month follow-up were 77% in Group A, 77% in Group B, and 90% in Group C.

"The findings showed that in managing APS, CsA alone and punctoplasty showed similar anatomical and functional success rates at the six-month follow-up. However, combining CsA with punctoplasty improved outcomes, enhancing anatomical and functional success," the researchers concluded.

Reference:

Sönmez, M. M., & Baydemir, E. E. (2025). Effects of Cyclosporine Eye Drop Use on the Success of Punctoplasty in Acquired Punctal Stenosis. Current Eye Research, 1–5. https://doi.org/10.1080/02713683.2025.2466659