Clinical Investigation of Therapeutic Effect and Extrusion Rate of Punctal Plug for Dry Eye Syndrome

ABSTRACT

PURPOSE: To investigte the extrusion rate of punctal plugs and to evaluate their long-term effectiveness related to punctal occlusion. METHODS: The subjects were 120 eyes of 60 patients with tear-deficient dry eye who underwent punctal occlusion using a silicone punctal plug from May 2003 to Jun 2004. They were followed up for 382.3+/-164.3 days. We studied the extrusion rate and the period of extrusion for each plug and examined the differences between the objective and subjective indicators of dry eye syndrome before and after plug insertion and between extruded and non-extruded punctal plugs. RESULTS: In this study, 25.8% of all plugs were extruded during the follow-up period. The majority of plugs (41.9%) were extruded within 100 days after plug insertion. As objective indicators, results of Schirmer test and BUT were significantly increased after plug insertion. As subjective indicators, the patients' clinical symptoms significantly improved. Patient use of artificial tear drops significantly decreased and was discontinued by 70.8% after plug insertion. There were however no significant differences between the extrusion group and the non-extrusion group in each case. CONCLUSIONS: Punctal plug occlusion therapy for tear-deficient dry eye is effective, but the extrusion rate is relatively high. Regardless of punctal plug extrusion, patients experienced a symptomatic improvement. Serious consideration of this fact may greatly aid in making therapeutic adaptations and maintaining a good relationship.