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SmartPlug versus silicone punctal plug therapy for dry eye: a prospective randomized trial.
Cornea. 2008 May; 27(4):391-4.C

Abstract

PURPOSE

To evaluate the clinical efficacy, retention rates, and complications of SmartPlug insertion compared with silicone punctal plugs in patients with dry eye.

METHODS

Thirty-six eyes with subjective symptoms of dry eye in addition to a tear film breakup time (TBUT) <5 seconds and evidence of ocular surface damage on rose Bengal or fluorescein staining were included. Treated eyes were randomized to either a silicone plug or SmartPlug inferior punctal occlusion. Pre- and posttreatment evaluations included subjective symptom scoring, tear meniscus height, TBUT, Schirmer test, fluorescein and rose Bengal staining, and artificial tear use.

RESULTS

After a mean follow-up period of 11.2 weeks, both the silicone plug- and SmartPlug-treated eyes showed significant improvement in symptom scoring (P = 0.002 and P = 0.005, respectively), TBUT (P = 0.035 and P = 0.009, respectively), and fluorescein (P = 0.024 and P = 0.016, respectively) and rose Bengal (P = 0.008 and P = 0.046, respectively) staining. There was no significant difference in these parameters between the 2 plugs. SmartPlug-, but not the silicone plug-treated eyes showed significant improvement in mean tear meniscus height (P = 0.037). The use of artificial tear supplements was reduced in 10 (55.6%) silicone- and 11 (61.1%) SmartPlug-treated eyes. Minor complications related to plug insertion were experienced in 4 (22%) silicone- and 2 (11%) SmartPlug-treated eyes. Spontaneous plug loss occurred with 6 (33%) silicone plugs.

CONCLUSIONS

This prospective randomized trial shows that SmartPlug insertion has equivalent clinical efficacy to the use of conventional silicone plugs. Both SmartPlug and silicone plug use can reduce dependency on tear supplements in >55% of patients with dry eye.

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Authors+Show Affiliations

Burgess PI
St John's Hospital, Livingston, UK. philipburgess@doctors.org.uk
Koay P
No affiliation info available
Clark P
No affiliation info available

MeSH

Acrylic ResinsAdultAgedDry Eye SyndromesFemaleFluoresceinFluorescent DyesHumansIntraoperative ComplicationsLacrimal ApparatusMaleMiddle AgedOphthalmic SolutionsPostoperative ComplicationsProspective StudiesProstheses and ImplantsRose BengalSilicone ElastomersTearsTreatment Outcome

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18434839

Citation

Burgess, Philip I., et al. "SmartPlug Versus Silicone Punctal Plug Therapy for Dry Eye: a Prospective Randomized Trial." Cornea, vol. 27, no. 4, 2008, pp. 391-4.
Burgess PI, Koay P, Clark P. SmartPlug versus silicone punctal plug therapy for dry eye: a prospective randomized trial. Cornea. 2008;27(4):391-4.
Burgess, P. I., Koay, P., & Clark, P. (2008). SmartPlug versus silicone punctal plug therapy for dry eye: a prospective randomized trial. Cornea, 27(4), 391-4. https://doi.org/10.1097/ICO.0b013e318160d030
Burgess PI, Koay P, Clark P. SmartPlug Versus Silicone Punctal Plug Therapy for Dry Eye: a Prospective Randomized Trial. Cornea. 2008;27(4):391-4. PubMed PMID: 18434839.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - SmartPlug versus silicone punctal plug therapy for dry eye: a prospective randomized trial. AU - Burgess,Philip I, AU - Koay,Peter, AU - Clark,Patricia, PY - 2008/4/25/pubmed PY - 2008/6/17/medline PY - 2008/4/25/entrez SP - 391 EP - 4 JF - Cornea JO - Cornea VL - 27 IS - 4 N2 - PURPOSE: To evaluate the clinical efficacy, retention rates, and complications of SmartPlug insertion compared with silicone punctal plugs in patients with dry eye. METHODS: Thirty-six eyes with subjective symptoms of dry eye in addition to a tear film breakup time (TBUT) <5 seconds and evidence of ocular surface damage on rose Bengal or fluorescein staining were included. Treated eyes were randomized to either a silicone plug or SmartPlug inferior punctal occlusion. Pre- and posttreatment evaluations included subjective symptom scoring, tear meniscus height, TBUT, Schirmer test, fluorescein and rose Bengal staining, and artificial tear use. RESULTS: After a mean follow-up period of 11.2 weeks, both the silicone plug- and SmartPlug-treated eyes showed significant improvement in symptom scoring (P = 0.002 and P = 0.005, respectively), TBUT (P = 0.035 and P = 0.009, respectively), and fluorescein (P = 0.024 and P = 0.016, respectively) and rose Bengal (P = 0.008 and P = 0.046, respectively) staining. There was no significant difference in these parameters between the 2 plugs. SmartPlug-, but not the silicone plug-treated eyes showed significant improvement in mean tear meniscus height (P = 0.037). The use of artificial tear supplements was reduced in 10 (55.6%) silicone- and 11 (61.1%) SmartPlug-treated eyes. Minor complications related to plug insertion were experienced in 4 (22%) silicone- and 2 (11%) SmartPlug-treated eyes. Spontaneous plug loss occurred with 6 (33%) silicone plugs. CONCLUSIONS: This prospective randomized trial shows that SmartPlug insertion has equivalent clinical efficacy to the use of conventional silicone plugs. Both SmartPlug and silicone plug use can reduce dependency on tear supplements in >55% of patients with dry eye. SN - 0277-3740 UR - https://www.unboundmedicine.com/medline/citation/18434839/SmartPlug_versus_silicone_punctal_plug_therapy_for_dry_eye:_a_prospective_randomized_trial_ L2 - https://doi.org/10.1097/ICO.0b013e318160d030 DB - PRIME DP - Unbound Medicine ER -