The Dry Eye Zone

Rebecca's Blog


Abstract: The plug hunt goes on...

Potential plug-ees take note.... 

To investigate the retention rate and complications of 2 different types of silicon lacrimal punctal plugs with the focus on the relationship to punctum size.

Don't forget there are umpteen on the market. 

A prospective, nonrandomized, interventional, comparative study.
Forty-four patients with dry eye syndrome received lacrimal punctal plug insertion with the Punctal Plug F (FCI Ophthalmics) and 30 patients received plug insertion with the Super Flex plug (Eagle Vision; Softplug-Oasis Medical Inc). In total, 110 plug insertion regions were performed using the Punctal Plug F (group A) and 110 insertion regions were carried out using Super Flex plug (group B). The gauging system of Eagle Vision was used before the lacrimal punctal plug insertion in all subjects. Plug conditions (retention rates, spontaneous plug loss, and removal) and complications related to lacrimal punctal sizes were compared between the 2 groups.
Retention rates were 70.4% in group A and 30.1% in group B at 6 months. Spontaneous plug loss occurrence was significant with the larger lacrimal punctum size in group A (P < .05), whereas no significant differences were observed between lacrimal punctum sizes and spontaneous loss in group B. Spontaneous plug loss occurrence was significant in elderly patients in group B (P < .05). Granuloma and injector troubles were observed in 1 and 2 cases in group A, respectively.

Those retention rates stink. BOTH of them. 

Don't be distracted by the 30% which is obviously ridiculous. If an entire group of patients averaged 70% retention, well geez, almost every second person lost a plug. And these things are casually referred to as "permanent".

Make sure your doctor knows how to size people for plugs and has more than two brands to choose from, that's all I can say. And definitely ask who pays to replace them if they fall out.
The Punctal Plug F seems to be more applicable for insertion into the smaller punctal sizes. Punctum size and age seem to be important factors in determining the appropriate types of lacrimal punctal plugs.
J Ophthalmol. 2013 Jan 11. pii: S0002-9394(12)00769-6. doi: 10.1016/j.ajo.2012.10.024. [Epub ahead of print]
Lacrimal Punctal Plugs in the Treatment of Dry Eye Disease.
Kaido M, Ishida R, Dogru M, Tsubota K.
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; Wada Eye Clinic, Chiba, Japan. Electronic address: