A recent Ocular Surgery News article by Mitchell A. Jackson, MD, “Punctal plugs an overlooked but effective treatment for dry eye syndrome,” discusses the benefits of punctal occlusion for patients with dry eye. Because dry eye syndrome (DES) can produce extreme discomfort for patients, physicians need a variety of tested, effective treatment tools at their disposal.
Before considering punctal plugs, Jackson emphasizes the importance of distinguishing between aqueous-deficient DES and evaporative DES. This can be established through tear film osmolarity testing (TearLab®) and an assessment of the stability, production and flow of the tear film. In addition, if inflammation is present on the ocular surface, this must be addressed before punctal plugs are inserted. Jackson will utilize topical drops, such as Lotemax® gel (Bausch + Lomb) and Restasis® (Allergan), and re-evaluate after an appropriate period of time to see if inflammation has been eliminated.
For aqueous-deficient dry eye patients, Jackson recommends the use of punctal plugs once any inflammation has been addressed. He prefers the Comfortear® Lacrisolve™ 180 Absorbable Punctum Plugs because of their high retention rate.
As he argues, “Because the Comfortear® Lacrisolve™ 180 is less prone to falling out than a silicone plug that rests on the surface of the punctum, I can evaluate if the therapy is effective without installing a plug that may need to be removed.” Jackson also recommends punctal plugs to treat post-operative dry eye following corneal inlay and cataract surgery.
To read the full article, visit Ocular Surgery News.
Mitchell A. Jackson, MD, is the Founder/Medical Director of JacksonEye, the premier ophthalmology clinic in the Chicago area.
Paragon BioTeck, Inc., has developed a line of absorbable and non-absorbable punctum plugs to provide occlusion therapy to treat symptoms associated with dry eye disease that may result from allergies, cataracts, or contact lens intolerance. Patients who are unsure whether occlusion therapy is right for them should talk with their eye doctor.