Direct Observation of Canaliculus after Punctal Plug Extrusion

Nishii, Masakazu; Yokoi, Norihiko; Wakayama, Miki; Kinoshita, Shigeru

doi:10.1016/s1542-0124(12)70513-x

Cited by 1 publication

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“…20 The plug loss rate varied from 30% to 68% in some studies according to the type of plug used. 21 Our procedure includes an objective measurement of the tear puncti diameter with a sizer that helped to choose the appropriate plug size. Punctal plugs provide a reversible occlusion of the puncti.…”

Section: Discussionmentioning

confidence: 99%

Immediate and Delayed Effects of Punctal Plug Insertion on Tear Meniscus Height in Severe Aqueous-Deficient Dry Eye

Hallali,

Guindolet,

Gabison

et al. 2024

Cornea

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Purpose: The aim of this study was to assess the immediate and delayed effects of tear punctal occlusion with punctal plugs on tear meniscus height (TMH) in severe aqueous-deficient dry eye (ADDE) disease. Methods: Consecutive patients with severe ADDE related to Sjögren syndrome or ocular graft-versus-host disease underwent inferior and superior occlusion with punctal plugs. TMH was measured using the LacryDiag ocular surface analyzer platform before, 10 minutes, and at least 1 month after punctal occlusion. The corneal fluorescein staining (CFS) score was graded with the Oxford scale (from 0 to 5). Ocular symptoms were graded with a visual analog scale (from 1 to 10). Results: We included 24 eyes of 24 patients (mean age 61 ± 9 years; mean follow-up 7 ± 5 months). The mean TMH was 0.19 ± 0.06 mm at baseline and increased significantly to 0.41 ± 0.13 mm (P < 0.001) and 0.46 ± 0.17 mm (P < 0.001) at 10 minutes after punctal plug insertion and at the end of follow-up, respectively. The median CFS score decreased from 3 ± 1 before plug insertion to 1 ± 2 at the end of follow-up (P < 0.001). Many patients (67%; n = 16) reported subjective improvement of symptoms. TMH was negatively correlated with the CFS score and visual analog scale score assessing symptoms. Conclusions: Upper and lower punctal occlusion increased TMH in patients with severe ADDE as soon as 10 minutes after plug insertion. TMH remained stable over time, which led to the relief of symptoms and reduced corneal staining.

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Section: Discussionmentioning

confidence: 99%