Efficacy and tolerability outcome after punctal occluion with ilicone plug in dry eye yndrome

PURPOE: ilicone punctal plug are widely ued to conerve moiture in tear-deficient eye. We tudied the efficacy and tolerability of punctal plug in ymptom reduction and improvement of ocular urface dieae parameter in dry eye yndrome. METHOD: We reviewed the record of 50 conecutive patient with dry eye yndrome who were ymptomatic depite maximally tolerable lubricant therapy and had bilateral lower punctal plug inertion. After plug inertion, all patient (41 women and nine men) had 6 month or more of follow-up. The ubject ranged in age from 22 to 57 year (mean, 30 year). We recorded ubjective and objective improvement of ocular urface dieae, frequency of lubricant ue, need for upper punctal occluion, and occurrence of complication after plug inertion. We determined plug retention rate uing Kaplan–Meier analye and aeed aociated factor uing Cox proportional hazard model. REULT: ix month after initial plug placement, 43 of 50 patient (86%) were ymptom free, 28 of them (56%) with plug alone, and 38 patient (76%) had topped uing lubricant on a daily bai. pontaneou lo of plug wa common, epecially in the initial 3 month of follow-up. Conidering all plug, the etimated probability of plug retention wa 63% after 6 month of follow-up. Puncta refitted after initial plug lo were twice a likely to loe the replacement plug (P = .02). Upper punctal plug howed a 4.3-fold higher rik of lo compared with plug inerted in lower puncta (P < .0001). CONCLUION: There i both a reduced dependency on artificial lubricant and relief of ymptom of dry eye after punctal plug. However, pontaneou plug lo occur in a ubtantial minority of patient. Patient education and cloe follow-up, particularly in the firt 3 month, i recommended to detect plug lo and enure adequate control of the dieae