Efficacy and tolerability outcomes after punctal occlusion with silicone plugs in dry eye syndrome☆
Section snippets
Methods
We reviewed the records of 50 consecutive patients (100 eyes) who had placement of silicone punctal plugs (modified Freeman “tapered-shaft” plug; Eagle Vision, Memphis, Tennessee; Softplug-Oasis Medical, Inc, Glendora, California) in both lower puncta at the Cornea and Ocular Immunology Clinics of the Massachusetts Eye and Ear Associates at the Brigham and Women’s Hospital, Boston. Patients with bilateral dry eye syndrome, as evidenced by Schirmer I test scores of 10 mm or less, who had
Results
Primary keratoconjunctivitis sicca was the underlying diagnosis in 23 patients (46%). Nine patients (18%) had a diagnosis of primary Sjogren syndrome, and seven (14%) had secondary Sjögren syndrome. Graft-versus- host disease was diagnosed in seven patients (14%), and the other four patients (8%) included one patient with superior limbic keratoconjunctivitis, one patient with radiation-induced dry eye, and two patients in whom keratoconjunctivitis sicca was further exacerbated by facial nerve
Discussion
The use of silicone punctal plugs increases comfort levels and lowers the use of supplemental lubrication in most patients with tear-deficient dry eye. The decreased use of supplemental lubrication may be economically beneficial, considering the high cost of preservative-free tear supplements used by a majority of these patients. In comparison with permanent punctal closure by thermal cauterization, this is a simple, painless, and easily reversible procedure. However, our data suggest that a
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2020, Ocular SurfaceCitation Excerpt :We found that spontaneous extrusion of punctal plugs occurs in a majority of oGVHD-associated DED patients within 90 days of plug placement. The retention rates reported in our study are consistent with previous reports of punctal plug retention in patients of DED, both with and without oGVHD [12,15–17,46–48]. The lower retention rate of punctal plugs in oGVHD DED patients has been attributed to punctal subepithelial fibrosis [48].
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This work was supported in part by a grant from Alcon Research Limited, Fort Worth, Texas.