Purpose:

The evaluation of long-term results of punctal plugs applied to dry eye patients and the potential problems they may bring about.

Material and Method:

In this study, we retrospectively assessed 30 eyes of 15 patients with moderate to advanced dry eyes who were applied punctal plug (5 mm) for treatment purpose and were observed for 12 months. The patients’ Ocular Surface Disease Index (OSDI ) scoring, Schimer-1 test (without topical anesthesia), tear film break-up time (TBUT) and ocular surface staining with fluorescein results were evaluated and compared before and after 6- and 12-month use of punctal plug. The patients were started on topical anti-inflammatory treatment and artificial tears two months before the application of the punctum plug.

Results:

The patients’ average age was 56.4±2.3 (range: 36-70) years, and the average follow-up period was 15 (12-30) months. The average OSDI score was statistically significantly decreased at 6 and 12 months when compared to the initial value (p<0.05). The average Schirmer-1 test values measured at 6 and 12 months were also statistically significantly increased compared with the initial value (p<0.05). The average Schirmer-1 test value at 12 months was considerably increased when compared with the 6th month’s value (p<0.05). The average TBUT was statistically significantly increased when compared to the values at 6 and 12 months (p<0.05). When the outcomes of ocular surface staining with fluorescein were evaluated, a significant decrease was seen at 6 and 12 months when compared to the initial value (p<0.05).

Discussion:

The punctal plug treatment associated with topical anti-inflammatory treatment for moderate and advanced dry eye patients is a reliable method. It decreases the dry eye symptoms and findings in the long term. (Turk J Ophthalmol 2011; 41: 225-9)

Keywords: Dry eye, punctal plug, topical anti-inflammatory treatment