title: Punctal occlusion in tear deficiency syndromes.
abstract: Punctal occlusion was carried out in 32 eyes with tear deficiency syndromes regardless of the preoperative Schirmer tear test values. Diagnoses included: keratoconjunctivitis sicca, Stevens-Johnson syndrome, congenital alacremia, and post-traumatic tear deficiency. Subjective symptomatic improvement was recorded in 97% of the eyes. Objective improvement was recorded as resolution or improvement of corneal ulceration, filamentary keratitis, and superficial punctate keratitis. All patients (100%) experienced improvement in one or more of these diagnostic signs. A tarsorrhaphy was required as adjunctive therapy to punctal occlusion in three eyes with Stevens-Johnson syndrome. Epiphora did not occur after surgery even though 16 eyes (50%) had preoperative Schirmer tear test values greater than 2 mm (range 0-15 mm). Artificial tears were discontinued or reduced to occasional use in 85% of eyes postocclusion of puncta. Eight puncta reopened; five of the eight required reocclusion. In this series, punctal occlusion was a safe and effective method of managing severe tear deficiency syndromes and should be considered more frequently in patients with the appropriate criteria.
mesh_terms: D006801:Humans; D007637:Keratoconjunctivitis / Q000628:therapy; D007766:Lacrimal Apparatus Diseases / Q000601:surgery*; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D013262:Stevens-Johnson Syndrome / Q000628:therapy
chemical_list: D009883:Ophthalmic Solutions