title: Long-term follow-up of punctal and proximal canalicular stenoses after silicone punctal plug treatment in dry eye patients.
abstract: OBJECTIVE
  To determine the clinical value and relevance of punctal and proximal canalicular stenoses after punctal plug therapy in moderate to severe dry eye syndrome.
  
  
  METHODS
  Retrospective, observational case series.
  
  
  METHODS
  Seventeen eyes were determined to have punctum or proximal canalicular stenoses after spontaneous loss of a collared silicone punctal plug. After initial diagnosis all patients had 12 months or more of follow-up (mean, 39; range, 12 to 87 months). The clinical data collected included gender and age of patients, localization of the stenosis, plug size, duration of punctal occlusion, subjective symptoms, objective ocular surface disease parameters, and occurrence of complications.
  
  
  RESULTS
  A statistically significant correlation between localization of the stenosis and plug size, and localization of the stenosis and duration of punctal occlusion could not be found. At follow-up, subjective symptoms (P < .01) and frequency of artificial tear application (P < .001) were significantly reduced compared to data before plug insertion. Schirmer I test results (P < .001), corneal fluorescein staining (P < .01), and rose bengal staining (P < .001) improved significantly, whereas tear break-up time (P < .2) and impression cytology scores of the conjunctival surface (P = .2) remained almost unchanged. Complications could not be found.
  
  
  CONCLUSIONS
  Within the observation period of up to seven years, all stenoses remained asymptomatic. Additionally, subjective symptoms and most dry eye parameters in our study population improved.
authors: Department of Ophthalmology, Medical University of Graz, Graz, Austria. ingrid.boldin@yahoo.de
authors: Ingrid
authors: I
authors: Boldin
authors: Angelika
authors: A
authors: Klein
authors: Eva-Maria
authors: EM
authors: Haller-Schober
authors: Jutta
authors: J
authors: Horwath-Winter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015352:Dry Eye Syndromes / Q000601:surgery*; D005260:Female; D015590:Fluorophotometry; D005500:Follow-Up Studies; D006801:Humans; D007765:Lacrimal Apparatus / Q000601:surgery*; D007767:Lacrimal Duct Obstruction / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D012826:Silicone Elastomers; D013666:Tears / Q000378:metabolism
chemical_list: D012826:Silicone Elastomers