title: Effect of punctal plugs in patients with low refractive errors considering refractive surgery.
abstract: OBJECTIVE
  To study the effect of punctal plug placement in patients undergoing refractive surgery for correction of poor vision.
  
  
  METHODS
  A retrospective study was performed of 12 patients (21 eyes) who presented for initial refractive surgery or retreatment after LASIK or photorefractive keratectomy to improve visual acuity. Uncorrected visual acuity (UCVA) was documented in each eye. If tear normalization test was positive (indicating dry eye), silicone punctal plugs were placed in the lower lids of both eyes. Subjective patient UCVA and Snellen UCVA were assessed at 1 month.
  
  
  RESULTS
  At 1 month, two eyes improved by three Snellen lines, nine eyes improved by two lines, seven eyes improved by one line, and three eyes remained unchanged. Uncorrected visual acuity was considered statistically significant (P < .0001) using the paired t test. No eye demonstrated decrease in visual acuity. One patient experienced punctal plug extrusion in both eyes. No other adverse outcomes were reported. One patient pursued additional refractive surgery after plug placement. No patient requested plug removal.
  
  
  CONCLUSIONS
  Patients with low refractive errors note improvement in visual acuity after punctal plug placement.
authors.affiliation: New York Eye and Ear Infirmary, New York, NY, USA.
authors.forename: Monica B
authors.initials: MB
authors.lastname: Khalil
authors.forename: Robert A
authors.initials: RA
authors.lastname: Latkany
authors.forename: Mark G
authors.initials: MG
authors.lastname: Speaker
authors.forename: Guopei
authors.initials: G
authors.lastname: Yu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D018903:Photorefractive Keratectomy; D019736:Prostheses and Implants / Q000009:adverse effects; D012030:Refractive Errors / Q000209:etiology*; D054140:Refractive Surgical Procedures; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity