title: Lacrimal punctum occlusion in the treatment of severe keratoconjunctivitis Sicca caused by Sjögren syndrome: a uniocular evaluation.
abstract: OBJECTIVE
  A controlled uniocular study to evaluate the short-term efficacy of lacrimal punctum occlusion in the treatment of severe dry eye caused by Sjögren syndrome.
  
  
  METHODS
  Uniocular punctum occlusion by punctum plug in the upper and lower puncta in 1 eye was performed in 20 patients with severe keratoconjunctivitis Sicca caused by Sjögren syndrome. To overcome possible interindividual variability between patients, the other eye, in the same patient, was not occluded and served as a control eye. The eye to be occluded was randomly selected. The patients were instructed to continue using their dry eye medications. Tear function tests (Schirmer test, rose Bengal test, and debris in de cul-de-sac) were performed in both eyes. Subjective complaints (discomfort) were registered for both eyes. All the above-mentioned data were collected before starting the treatment and at least 6 weeks later. The above-mentioned parameters were compared and statistically analyzed in both eyes.
  
  
  RESULTS
  Of the 20 patients, 7 patients dropped out. The remaining 13 patients completed the final analysis. In the occluded eye, we found a significant improvement in both the subjective complaints and the rose Bengal score, but the Schirmer test and the tear mucus score did not change.
  
  
  CONCLUSIONS
  Punctum occlusion therapy in a short-term study improved the rose Bengal score and discomfort score in our patients and thus may be helpful in the treatment of severe dry eye caused by Sjögren syndrome.
authors.affiliation: Department of Ophthalmology, Academic Hospital, University of Groningen, Groningen, The Netherlands. k.mansour@ohk.umcg.nl
authors.forename: Khaled
authors.initials: K
authors.lastname: Mansour
authors.forename: Carolien J
authors.initials: CJ
authors.lastname: Leonhardt
authors.forename: Wouter W
authors.initials: WW
authors.lastname: Kalk
authors.forename: Hendrika
authors.initials: H
authors.lastname: Bootsma
authors.forename: Klaas J
authors.initials: KJ
authors.lastname: Bruin
authors.forename: Lieuwe J
authors.initials: LJ
authors.lastname: Blanksma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000378:metabolism / Q000601:surgery*; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000295:instrumentation*; D012720:Severity of Illness Index; D012859:Sjogren's Syndrome / Q000150:complications*; D013666:Tears / Q000378:metabolism*; D016896:Treatment Outcome