Outcome of Punctal Plug Occlusion Therapy for Severe Dry Eye Syndrome

Abstract

Punctal occlusion using a silicone plug is one way of treating tear-deficient dry eye and it has been reported to be effective. We studied the outcome of punctal plug occlusion therapy for severe dry eye syndrome at our dry eye clinic. Subjects were 76 eyes of 51 patients [6 eyes of 5 males, 70 eyes of 46 females, mean age: 58.6 +/- 13.4 (mean +/- standard deviation), 49 eyes of 30 patients with Sjögren's syndrome, 27 eyes of 21 patients without Sjögren's syndrome] with severe tear-deficient dry eye who underwent punctal occlusion using a silicone plug (Punctal plug, FCI Co. Ltd, France) during the period of Nov. 1996 to Mar. 2000 at our dry eye clinic. They were under observation for 632 +/- 405 days (mean +/- standard deviation). We studied if there is difference in tolerance between the sizes of punctal plug, compared epithelial damage before and after plug insertion, and studied relief in symptoms using self-assessment. In tolerance of punctal plugs, 55.9% of all plugs were lost during our follow up, but there was no difference in time to loss between the sizes. Epithelial damage was reduced (p < 0.001). Dryness was the most reduced symptom: 26 patients (79%) got better, and only epiphora was increased, with 12 patients (36%) complaining slightly. Punctal plug occlusion therapy for tear-deficient dry eye is conclusively very effective.