Comparison of extrusion rate for two different designs of punctal plugs

Abstract

Purpose Punctal occlusion using a silicone plug is an effective treatment for severe tear-deficient dry eye. At present, plugs from two companies are available in Japan [Eagle plug (EP); Eagle Vision, Punctal plug (PP); FCI]. We compared the extrusion rate between EP and PP in our dry eye clinic. Subjects and methods Subjects were 20 eyes of 18 patients for EP [5 eyes from 5 males, 15 eyes from 13 females, age: 58.1±17.5 (mean±standard deviation)] and 76 eyes of 51 patients for PP (6 eyes from 5 males, 70 eyes from 46 females, age: 58.6±13.4), 62 eyes from 44 patients with Sjögren syndrome, 34 eyes from 25 patients with non-Sjögren syndrome with severe tear-deficient dry eye. These patients were treated during the period of November 1996 to February 2002 in our dry eye clinic. We compared the extrusion rate for each plug and the necessity of reinsertion of the plug. Results In the examination for EP, 72.2% of the plugs were extruded during the follow-up period. The average period (59 days) until the extrusion was completed was significantly shorter than for PP ( P<0.0001). In the examination of PP, 55.9% were extruded, and the average period until the extrusion was 287 days. Significant improvement of corneal epithelial damage was seen with PP after insertion of the plug. For the PP, reinsertion of plugs was sometimes impossible, probably because of the granulation formed inside the canaliculus, while for EP, reinsertion of the plugs was possible for all cases. Discussion EP becomes extruded more easily than PP, and it seems that forms more easily inside PP.