Evaluation of efficacy of plasma assisted noninvasive surgery (PANIS) as a novel approach for temporary punctal occlusion: a clinical case series
Farhad Nejat1 *, khosrow Jadidi1 , Shima Eghtedari1
- Vision health research center
Abstract: 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.
