title: A new punctal plug insertion technique to prevent intracanalicular plug migration.
abstract: OBJECTIVE
  To evaluate the intracanalicular migration rate during plug insertion with a new plug insertion technique compared with a standard technique.
  
  
  METHODS
  Interventional, nonrandomized, comparative study.
  
  
  METHODS
  Forty-five patients with dry eye syndrome underwent a punctal plug insertion with the new technique, and 33 patients underwent a punctal plug insertion with a standard technique at the dry eye subspecialty outpatient clinic of the Department of Ophthalmology at Keio University. Tear function examinations and ocular surface evaluations, including the Schirmer test, tear film breakup time, fluorescein and Rose Bengal vital staining scores, were performed before punctal plug insertion. Super Flex Punctum Plugs (Eagle Vision, Memphis, Tennessee, USA; Softplug-Oasis Medical Inc, Glendora, California, USA) were implanted in all subjects with both techniques. In total, 120 procedures were carried out with the new technique and 132 procedures with the standard technique.
  
  
  RESULTS
  There were no statistical differences between the two groups in tear function and ocular surface staining scores (P > .05). There was no intracanalicular plug migration with the new insertion technique, whereas there were 18 incidents of intracanalicular migration of 132 standard plug insertion procedures (13.6%).
  
  
  CONCLUSIONS
  The new plug insertion technique seems to be effective in eliminating intracanalicular plug migration during the insertion procedure.
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Minako
authors.initials: M
authors.lastname: Kaido
authors.forename: Reiko
authors.initials: R
authors.lastname: Ishida
authors.forename: Murat
authors.initials: M
authors.lastname: Dogru
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015352:Dry Eye Syndromes / Q000601:surgery*; D005260:Female; D005548:Foreign-Body Migration / Q000517:prevention & control*; D006801:Humans; D007765:Lacrimal Apparatus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*; D012826:Silicone Elastomers; D013666:Tears / Q000502:physiology
chemical_list: D012826:Silicone Elastomers