Tags

Type your tag names separated by a space and hit enter

Efficacy and tolerability outcomes after punctal occlusion with silicone plugs in dry eye syndrome.
Am J Ophthalmol. 2001 Jan; 131(1):30-6.AJ

Abstract

PURPOSE

Silicone punctal plugs are widely used to conserve moisture in tear-deficient eyes. We studied the efficacy and tolerability of punctal plugs in symptom reduction and improvement of ocular surface disease parameters in dry eye syndrome.

METHODS

We reviewed the records of 50 consecutive patients with dry eye syndrome who were symptomatic despite maximally tolerable lubricant therapy and had bilateral lower punctal plug insertion. After plug insertion, all patients (41 women and nine men) had 6 months or more of follow-up. The subjects ranged in age from 22 to 57 years (mean, 30 years). We recorded subjective and objective improvement of ocular surface disease, frequency of lubricant use, need for upper punctal occlusion, and occurrence of complications after plug insertion. We determined plug retention rates using Kaplan-Meier analyses and assessed associated factors using Cox proportional hazards models.

RESULTS

Six months after initial plug placement, 43 of 50 patients (86%) were symptom free, 28 of them (56%) with plugs alone, and 38 patients (76%) had stopped using lubricants on a daily basis. Spontaneous loss of plugs was common, especially in the initial 3 months of follow-up. Considering all plugs, the estimated probability of plug retention was 63% after 6 months of follow-up. Puncta refitted after initial plug loss were twice as likely to lose the replacement plug (P =.02). Upper punctal plugs showed a 4.3-fold higher risk of loss compared with plugs inserted in lower puncta (P <.0001).

CONCLUSIONS

There is both a reduced dependency on artificial lubricants and relief of symptoms of dry eye after punctal plugs. However, spontaneous plug loss occurs in a substantial minority of patients. Patient education and close follow-up, particularly in the first 3 months, is recommended to detect plug loss and ensure adequate control of the disease.

Authors+Show Affiliations

Massachusetts Eye and Ear Associates, Brigham and Women's Hospital, Schepens Eye Research Institute, and the Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11162976

Citation

Balaram, M, et al. "Efficacy and Tolerability Outcomes After Punctal Occlusion With Silicone Plugs in Dry Eye Syndrome." American Journal of Ophthalmology, vol. 131, no. 1, 2001, pp. 30-6.
Balaram M, Schaumberg DA, Dana MR. Efficacy and tolerability outcomes after punctal occlusion with silicone plugs in dry eye syndrome. Am J Ophthalmol. 2001;131(1):30-6.
Balaram, M., Schaumberg, D. A., & Dana, M. R. (2001). Efficacy and tolerability outcomes after punctal occlusion with silicone plugs in dry eye syndrome. American Journal of Ophthalmology, 131(1), 30-6.
Balaram M, Schaumberg DA, Dana MR. Efficacy and Tolerability Outcomes After Punctal Occlusion With Silicone Plugs in Dry Eye Syndrome. Am J Ophthalmol. 2001;131(1):30-6. PubMed PMID: 11162976.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and tolerability outcomes after punctal occlusion with silicone plugs in dry eye syndrome. AU - Balaram,M, AU - Schaumberg,D A, AU - Dana,M R, PY - 2001/2/13/pubmed PY - 2001/3/10/medline PY - 2001/2/13/entrez SP - 30 EP - 6 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 131 IS - 1 N2 - PURPOSE: Silicone punctal plugs are widely used to conserve moisture in tear-deficient eyes. We studied the efficacy and tolerability of punctal plugs in symptom reduction and improvement of ocular surface disease parameters in dry eye syndrome. METHODS: We reviewed the records of 50 consecutive patients with dry eye syndrome who were symptomatic despite maximally tolerable lubricant therapy and had bilateral lower punctal plug insertion. After plug insertion, all patients (41 women and nine men) had 6 months or more of follow-up. The subjects ranged in age from 22 to 57 years (mean, 30 years). We recorded subjective and objective improvement of ocular surface disease, frequency of lubricant use, need for upper punctal occlusion, and occurrence of complications after plug insertion. We determined plug retention rates using Kaplan-Meier analyses and assessed associated factors using Cox proportional hazards models. RESULTS: Six months after initial plug placement, 43 of 50 patients (86%) were symptom free, 28 of them (56%) with plugs alone, and 38 patients (76%) had stopped using lubricants on a daily basis. Spontaneous loss of plugs was common, especially in the initial 3 months of follow-up. Considering all plugs, the estimated probability of plug retention was 63% after 6 months of follow-up. Puncta refitted after initial plug loss were twice as likely to lose the replacement plug (P =.02). Upper punctal plugs showed a 4.3-fold higher risk of loss compared with plugs inserted in lower puncta (P <.0001). CONCLUSIONS: There is both a reduced dependency on artificial lubricants and relief of symptoms of dry eye after punctal plugs. However, spontaneous plug loss occurs in a substantial minority of patients. Patient education and close follow-up, particularly in the first 3 months, is recommended to detect plug loss and ensure adequate control of the disease. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/11162976/Efficacy_and_tolerability_outcomes_after_punctal_occlusion_with_silicone_plugs_in_dry_eye_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002939400006206 DB - PRIME DP - Unbound Medicine ER -