Tear Film and Drainage after Selective Punctal Occlusion Using Polydioxanone Plugs in Dry Eye Patients

ABSTRACT

Purpose@#To assess changes in the tear film and delayed tear drainage after upper or lower, or combined upper and lower, punctal occlusion using dissolvable polydioxanone plugs in patients with dry eye. @*Methods@#In total, 40 dry eye patients (80 eyes) were enrolled four groups of 10 (20 eyes) with no, lower, upper, and lower and upper punctal occlusions. Dissolvable polydioxanone plugs were placed. The tear break-up time (tBUT) and the tear meniscus height (TMH) were measured, and the Schirmer I test and dye disappearance test (DDT) were performed at baseline and 2 weeks after the procedure. @*Results@#Compared to the control group, all three test groups exhibited significant changes in the tBUT, the DDT test, and the TMH after polydioxanone plug placement (all p < 0.05). The group with both upper and lower punctal occlusions exhibited more delayed tear drainage than the other test groups. A lower punctal occlusion significantly delayed tear drainage to a greater extent than did an upper punctal occlusion (p = 0.010). @*Conclusions@#In dry eye patients, a polydioxanone plug improved the tBUT and TMH, and the DDT score. The tear drainage delay increased in the order both, lower, and upper punctal occlusion(s).