[Effects of silicone punctal plugs for tear deficiency dry eye patients].

OBJECTIVE

To evaluate the efficacy of silicone punctual plug for treating aqueous tear deficiency dry eye patients.

METHODS

Prospective consecutive cases study. Silicone punctal plugs (France Chirurgie Instrumentation) were inserted into lower canaliculus in 65 tear deficiency dry eye patients (65 eyes). The clinical data collected included sex and age of the patients, frequency of lubricant use, the Ocular Surface Disease Index (OSDI) scores, slit lamp microscope examination, Schirmer I test (SIT) (with anesthesia), tear break-up time (TBUT), and ocular surface staining with fluoresce in sodium. All examinations were recorded at baseline, 6 weeks and 6 months after punctal occlusion.

RESULTS

There were 41 women and 24 men in this study, and their average age was 41.77 years old. The dry eye symptoms improved in 57 (87.69%) of 65 eyes at 6 months follow-up. The frequency of lubricant use was significantly decreased in these eyes (χ(2) = 81.97, P < 0.01). More importantly, the symptoms disappeared in 25 (38.46%) eyes, which did not need lubricant any more. At baseline, 6 weeks and 6 months after punctal occlusion, OSDI mean score was 37.32 ± 2.41, 19.60 ± 8.07 and 18.17 ± 7.93, respectively (F = 344.10, P < 0.01); mean SIT result was (3.03 ± 0.75) mm, (6.66 ± 2.10) mm and (6.75 ± 2.16) mm, respectively (F = 169.59, P < 0.01); mean TBUT was (2.91 ± 0.76) s, (7.02 ± 2.39) s and (7.57 ± 2.38) s, respectively (F = 242.00, P < 0.01). Compared with the baseline data, hyperemia of conjunctiva grading and ocular surface staining scores were also improved significantly after plug insertion, and all of these differences were statistically significant. Foreign body sensation was the most common complication in our study (12 eyes, 18.46%). Epiphora (4 eyes, 6.15%), partial extrusion (3 eyes, 4.62%), and total extrusion (3 eyes, 4.62%) were the other complications encountered.

CONCLUSION

Silicone punctal plug insertion is a stable, effective and safety method for the treatment of tear deficiency dry eye.