title: [Study of change of size of the punctum before insertion and after extrusion of a punctal plug and selection of an appropriate plug for reinsertion].
abstract: OBJECTIVE
  In cases when the reinsertion of punctal plugs is considered, enlargement of the punctum is often experienced and a larger punctal plug is sometimes required for reinsertion. We therefore investigated the change in the size of the punctum before insertion and after extrusion of a punctal plug and the selection of an appropriate punctal plug for reinsertion.
  
  
  METHODS
  There were 70 cases where punctal plugs were reinserted (37 eyes from 32 patients) because of extrusion of the plugs. A retrospective study was performed with regard to the change in the size of the punctum before insertion and after extrusion of the punctal plugs, and with regard to the type of plug reinserted.
  
  
  RESULTS
  There were significant changes in the size of the punctum before insertion [0.70 +/- 0.09 (mean +/- standard deviation) mm] and after extrusion (0.78 +/- 0.07 mm) of the punctal plug (p < 0.001). In 22 cases of 23 cases which experienced extrusion of the 0.8 mm Eagle plug (EP; Eagle Vision), Punctal plugs (PP; FCI) of M size were selected for reinsertion, because there are no EPs larger than 0.8 mm available for reinsertion.
  
  
  CONCLUSIONS
  After extrusion of the punctal plug, the punctum is likely to be enlarged, resulting in the need to select a larger punctal plug. Therefore, cases which experienced extrusion of an EP were likely to eventually have the EP replaced by a PP during follow-up treatment.
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Inagaki
authors.forename: Norihiko
authors.initials: N
authors.lastname: Yokoi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Nishii
authors.forename: Aoi
authors.initials: A
authors.lastname: Komuro
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kinoshita
mesh_terms: D000368:Aged; D015352:Dry Eye Syndromes / Q000601:surgery; D005123:Eye / Q000473:pathology*; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D019736:Prostheses and Implants; D011475:Prosthesis Failure; D019919:Prosthesis Implantation