Background: Punctal stenosis is a common cause of epiphora, and several treatment options are available for this disease.
Aim of the Study: to compare TSP and PPP for management of epiphora due to stenoses of the lacrimal puncta.
Patients and Methods: this is a non-randomized, interventional, prospective, comparative investigation that included 20 eyes having punctal stenosis divided into 2 groups. Group A (10 eyes) has been managed via rectangular three-snip punctoplasty and Group B (10 eyes) has been managed via insertion of polyvinylpyrrolidone PPP in the inferior punctum. The study was performed in Al-Azhar University Hospitals' ophthalmology department.

Results: The mean age was 54.30±13.85 years they were 13 males and 7 females. Epiphora Grade 4 or 5, improved post-operatively to Grade 0 or 1 in 70% of Group A eyes compared with 80% of Group B eyes. Fluorecein dye disappearance test grade 2 or 3,improved post-operatively to grade 1 in (80%) of Group A eyes compared with (90%)of Group B eyes. Restenosis was occurred in 20% of Group A eyes versus 10% of Group B eyes after falling during follow up at one month. Regarding safety, the two procedures were well-tolerated without intra-operative or post-operative complications Group B and apart occurred in 30% of Group A eyes with three-snip as canaliculitis, eyelid swelling and bleeding in the early post-operative period.
Conclusion: Both TSP and PPP have shown safety and effectiveness in treating acquired punctal stenosis. But, PPP insertion is less-invasive, better-tolerated, with superior and stable outcomes in comparison to TSP.