Punctal plugs for post-LASIK dry eye

1
Punctal plugs for post-LASIK dry eye

• Ikuko Toda1
• Kazuo Tsubota2

1Minamiaoyama Eye Clinic, Tokyo Japan 2Keio
University, School of Medicine, Tokyo, Japan
Finantial interest none
2
Purpose
To evaluate the efficacy of punctal plugs for
patients with post-LASIK dry eye.
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Patients

• 35 eyes in 19 patients who underwent LASIK.
• Fulfilled the Japanese dry eye criteria at 1
  month postoperatively.
• Plug group (20 eyes of 10 patients)
  Control group (15 eyes in 9 patients)
• Punctal plugs were inserted into superior and
  inferior puncta in the plug group.
• An artificial tear (0.3 hyaluronic acid, 5 times
  a day) was prescribed for both groups.

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Methods

• Uncorrected and best corrected visual acuity
  (UCVA and BCVA)
• Refraction
• Visual acuity after 0 and 10 seconds of eye
  opening (FVA-0 and FVA-10functional visual
  acuity)
• SRI after 0 and 10 seconds eye of opening (SRI-0
  and SRI-10)
• Corneal sensitivity
• Schirmer test
• Fluorescein staining
• Tear break-up time (TBUT)
• Dry eye symptoms

1. Above factors were compared between the groups at
   1 month and 3 months postoperatively.
2. The change of these data from 1 to 3 months were
   compared between the groups.

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UCVA and FVA
Before plug insertion
N0.029
0 sec (FVA-0)
10 sec (FVA-10)
N0.021
plug
control
After plug insertion
0 sec (FVA-0)
10 sec (FVA-10)
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SRI
N0.022
After plug insertion
Before plug insertion
0 sec (SRI-0)
10 sec (SRI-10)
0 sec (SRI-0)
10 sec (SRI-10)
plug
control
7
Corneal sensitivity
NNS
8
Tear function
Schirmer test
TBUT
N0.008
NNS
9
Fluorecsein staining
N0.020
10
Symptoms
Dryness
N0.020
N0.008
Foreign body sensation
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Before plug insertion
After plug insertion
FVA-0 (LogMAR) -0.10
FVA-10 0.20
Decreased BCVA (line) -3
FVA-0 (LogMAR) -0.10
FVA-10 -0.10
Decreased BCVA (line) -1
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Conclusion

• Our results suggest that punctal occlusion for
  both puncta is effective for patients with
  post-LASIK dry eye, that can not be controlled
  only by artificial tears.
• Punctal plugs are beneficial for these patients
  by improving not only dry eye symptoms and tear
  function, but also quality of vision, such as
  functional visual acuity.