PDF(Pubmed)
Abstract：
We report a case series of supernumerary puncta-canaliculi, a very rare congenital anomaly, and describe different clinical presentations and new treatment options. This is a retrospective chart review of patients diagnosed with supernumerary lacrimal puncta during the time between June 2015 and December 2021 at the Research Institute of Ophthalmology, Giza, Egypt. Four patients (two females and two males) with a mean presenting age of 54 ± 14 years had unilateral double puncta. Of those four patients, three had double puncta on the right lower eyelid whereas one had double puncta on the left upper and lower eyelid. In one of the three patients, the double puncta anomaly was an incidental finding, and the patient was asymptomatic. The other three patients had associated epiphora. All four patients were found to have patent double puncta with no mechanical obstruction. No surgical interventions were necessary for all four patients as one resolved after discontinuing the topical eye drops. Another patient resolved after the diagnostic probing of the puncta, and the third asymptomatic patient required no interventions. Epiphora in the fourth patient resolved with botulinum toxin injection in the lacrimal gland. Accessory lacrimal puncta can present in patients as an incidental asymptomatic finding or patients may present with epiphora. Patients who present with unilateral epiphora, dry eye, or canaliculitis should be carefully evaluated with a detailed slit-lamp examination using lid eversion to appreciate potentially easily missed supernumerary lacrimal puncta.
摘要：
我们报告了一系列的数字斑点骨，一种非常罕见的先天性异常,并描述不同的临床表现和新的治疗方案。这是2015年6月至2021年12月在眼科研究所诊断为多余泪点的患者的回顾性图表回顾，吉萨,埃及。平均年龄为54±14岁的四名患者（两名女性和两名男性）患有单侧双点。在这四个病人中,三个人的右下眼睑有双点，而一个人的左上下眼睑有双点。在三个病人中的一个，双点异常是偶然发现的，患者无症状。其他三名患者有伴发的泪滴。所有四名患者均被发现有双点专利，没有机械阻塞。所有四名患者都不需要手术干预，因为一名患者在停止局部滴眼液后得到解决。另一名患者在诊断探测puncta后得到了解决，第三位无症状患者不需要干预.第四例患者通过在泪腺中注射肉毒杆菌毒素解决了主唇。副泪点可以作为无症状的偶然发现出现在患者中，或者患者可能出现溢泪。表现为单侧顿唇的患者，干眼症,或泪小管炎应该通过详细的裂隙灯检查仔细评估，使用眼睑外翻，以了解可能容易错过的多余泪点。
