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Evaluation of efficacy of plasma assisted noninvasive surgery (PANIS) as a novel approach for temporary punctal occlusion: a clinical case series

Volume 6, Issue 6, December 2021    |    PP. 421-432    |PDF (222 K)|    Pub. Date: October 7, 2021
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Farhad Nejat, Vision health research center, Tehran, Iran
Khosrow Jadidi, Vision health research center, Tehran, Iran
Shima Eghtedari, Vision health research center, Tehran, Iran
Nazanin-Sadat Nabavi, Vision health research center, Tehran, Iran

Background: Several studies have reported plasma-assisted noninvasive surgery (PANIS method) as a simple, inexpensive, office-based, minimally invasive, effective technique for treating some ocular surface diseases. This study aims to explore the efficacy of this method for occluding tear drainage system, temporary, in order to treat dry eye disease.
Methods: Study was undertaken in six patients with moderate to severe dry eye (Schirmer’s test < 10 mm and TBUT 10 sec). The inferior puncta were fused using white handpiece of the plasma generator device (Plexr, GMV s.r.l Grottaferrata, Italy) under topical anesthesia and they remained occlude for 2-5 days. The efficacy of the PANIS method was assessed with comprising Refraction, visual acuity, intraocular pressure (IOP), corneal fluorescein staining score (CFS), contrast sensitivity (CS), Schirmer test values, dry eye tests, and ocular surface disease index (OSDI) questionnaire which were collected before, 1week, 1month and 6 months after the procedure and during the first week after this treatment, the slit-lamp examination was performed every day.
Results: All patients showed a significant decrease in corneal fluorescein staining score (CFS) and OSDI questionnaire. In the first three days after procedure, tear meniscus height and tear beak-up time had remarkably improved. Moreover, daily slit-lamp examinations during the first week showed that puncta remained occlude for 2-5 days. In addition, refraction, visual acuity and intraocular pressure showed no considerable change during the 6-month follow-up.
Conclusion: According to the findings, the PANIS method seems to be a temporary effective approach for treating dry eye disease (DED). Since no Signs and symptoms of DED were observed within the first week, this novel technique was concluded to be able of evaluating pre-permanent punctual occlusion and also first week after procedure would make a good time for repairing damaged ocular surface with any particular reasons.

Temporary punctal occlusion; Plasma; Dry eye disease; Ocular surface disease

Cite this paper
Farhad Nejat, Khosrow Jadidi, Shima Eghtedari, Nazanin-Sadat Nabavi, Evaluation of efficacy of plasma assisted noninvasive surgery (PANIS) as a novel approach for temporary punctal occlusion: a clinical case series, SCIREA Journal of Clinical Medicine. Vol. 6 , No. 6 , 2021 , pp. 421 - 432 .


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