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Five Misconceptions Related to Punctal Plugs in Dry Eye Management.
Cornea. 2018 Nov; 37 Suppl 1:S58-S61.C

Abstract

Punctal plugs are an effective treatment option for patients with aqueous-deficient dry eye refractory to topical medications. However, punctal plugs are not commonly used in clinical practice mainly because of various misconceptions, rather than clinical complications. We analyzed previous studies and present 5 misconceptions related to punctal plugs. The first and most important misconception is that ocular surface inflammation should be sufficiently controlled before punctal plug insertion. However, it is unclear how ocular surface inflammation can be sufficiently controlled in patients refractory to conventional topical medications. The second misconception is that silicone punctal plugs are made of nonabsorbable materials and, therefore, permanent. In fact, silicone plugs are reversible and can be easily removed if necessary. Therefore, depending on the specific type, nonabsorbable plugs may be classified as reversible or permanent. The third misconception is that punctal plugs disrupt normal tear drainage. However, punctal plugs maintain natural tears on the ocular surface for extended periods and reduce the frequency of artificial tear use. The fourth is that all punctal and canalicular plugs have similar effects. The efficacy and complication rates differ depending on plug types. The fifth misconception about punctal plugs is that they are effective only in aqueous-deficient dry eye disease. Many studies have reported that plugs are effective in a variety of ocular diseases and conditions. Understanding these 5 misconceptions may provide an opportunity to rethink the use of silicone punctal plugs in clinical practice.

Authors+Show Affiliations

Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30211751

Citation

Song, Jong Suk, et al. "Five Misconceptions Related to Punctal Plugs in Dry Eye Management." Cornea, vol. 37 Suppl 1, 2018, pp. S58-S61.
Song JS, Woo IH, Eom Y, et al. Five Misconceptions Related to Punctal Plugs in Dry Eye Management. Cornea. 2018;37 Suppl 1:S58-S61.
Song, J. S., Woo, I. H., Eom, Y., & Kim, H. M. (2018). Five Misconceptions Related to Punctal Plugs in Dry Eye Management. Cornea, 37 Suppl 1, S58-S61. https://doi.org/10.1097/ICO.0000000000001734
Song JS, et al. Five Misconceptions Related to Punctal Plugs in Dry Eye Management. Cornea. 2018;37 Suppl 1:S58-S61. PubMed PMID: 30211751.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Five Misconceptions Related to Punctal Plugs in Dry Eye Management. AU - Song,Jong Suk, AU - Woo,In Ho, AU - Eom,Youngsub, AU - Kim,Hyo Myung, PY - 2018/9/14/pubmed PY - 2018/10/27/medline PY - 2018/9/14/entrez SP - S58 EP - S61 JF - Cornea JO - Cornea VL - 37 Suppl 1 N2 - Punctal plugs are an effective treatment option for patients with aqueous-deficient dry eye refractory to topical medications. However, punctal plugs are not commonly used in clinical practice mainly because of various misconceptions, rather than clinical complications. We analyzed previous studies and present 5 misconceptions related to punctal plugs. The first and most important misconception is that ocular surface inflammation should be sufficiently controlled before punctal plug insertion. However, it is unclear how ocular surface inflammation can be sufficiently controlled in patients refractory to conventional topical medications. The second misconception is that silicone punctal plugs are made of nonabsorbable materials and, therefore, permanent. In fact, silicone plugs are reversible and can be easily removed if necessary. Therefore, depending on the specific type, nonabsorbable plugs may be classified as reversible or permanent. The third misconception is that punctal plugs disrupt normal tear drainage. However, punctal plugs maintain natural tears on the ocular surface for extended periods and reduce the frequency of artificial tear use. The fourth is that all punctal and canalicular plugs have similar effects. The efficacy and complication rates differ depending on plug types. The fifth misconception about punctal plugs is that they are effective only in aqueous-deficient dry eye disease. Many studies have reported that plugs are effective in a variety of ocular diseases and conditions. Understanding these 5 misconceptions may provide an opportunity to rethink the use of silicone punctal plugs in clinical practice. SN - 1536-4798 UR - https://www.unboundmedicine.com/medline/citation/30211751/Five_Misconceptions_Related_to_Punctal_Plugs_in_Dry_Eye_Management_ L2 - http://dx.doi.org/10.1097/ICO.0000000000001734 DB - PRIME DP - Unbound Medicine ER -