title: [Clinical investigation of the extrusion rate and other complications of the new Super Flex Plug punctal plug and other plugs].
abstract: OBJECTIVE
  Currently, there are only three punctum plugs available for use in Japan [EaglePlug (EP), Eagle Flex Plug (FP), and Punctal Plug (PP)]. This study investigated the effectiveness of the newly marketed Super Flex Plug (SFP).
  
  
  METHODS
  This study involved 291 eyes of 224 severe dry eye patients treated at the dry eye clinic of Kyoto Prefectural University of Medicine, Kyoto, Japan. For the SFP, EP, FP, and PP, this study compared the extrusion rate of each plug and other complications, including enlargement of the size of the punctum after extrusion, granulation, and the accumulation of soft whitish material around the plugs.
  
  
  RESULTS
  During the evaluation periods, the elapsed times until extrusion were significantly longer for SFP than for EP and FP(p<0.001). In all cases, there was a significant enlargement of the size of the punctum (mm) after extrusion of the SFP [0.74 +/- 0.13 (mean +/- SD)] as compared to that before insertion [0.62 +/- 0.14 (p < 0.0001)]. Granulation formed in 1.7% of the SFP cases, but the frequency was lower than that in PP cases (19%). No soft whitish material around the plug was seen in SFP-inserted eyes.
  
  
  CONCLUSIONS
  The SFP was harder to extrude, and was found to cause granulation. After extrusion of the SFP, the punctum was likely to be enlarged.
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Nasu
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: Kayoko
authors.initials: K
authors.lastname: Inagaki
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kinoshita
mesh_terms: D015352:Dry Eye Syndromes / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects; D011475:Prosthesis Failure