title: Retention rate of silicone punctal plugs placed by residents in a general clinic setting.
abstract: OBJECTIVE
  To evaluate the retention rate of silicone punctal plugs placed in patients with dry eye in a general clinic setting by ophthalmology residents.
  
  
  METHODS
  A cohort study reviewing charts of 88 patients who underwent punctal plug placement in the resident clinic at The New York Eye and Ear Infirmary from January 2007 to November 2008. Information recorded included age and sex of the patients, date of insertion, initial versus replacement plug, type and size of plug, location of insertion, and retention versus spontaneous extrusion versus removal of plugs at follow-up visits. Follow-up data were recorded at 30 and 60 days.
  
  
  RESULTS
  Follow-up data for 106 plug placements were available at 30 days. A total of 71.7% were retained, 23.6% were lost, and 4.7% were removed. At 60 days, data were available for 96 plug placements. A total of 50.0% were retained, 47.9% were lost, 5.2% had been removed prior to 60 days, and 2.1% had been replaced prior to 60 days.
  
  
  CONCLUSIONS
  Spontaneous extrusion is a common complication in punctal plug insertion, and the retention rate in a general clinic setting with ophthalmology residents is low. This may suggest that attention should be placed on improved instruction in placement techniques and sizing, better patient education on avoidance of rubbing, and importance of follow-up. It may also support the need for better designed plugs or considering alternatives to the silicone plugs, or the placement of such plugs in a dedicated punctal plug clinic under supervision of an experienced attending physician.
authors.affiliation: New York Eye and Ear Infirmary, New York, New York, USA.
authors.forename: Neeti B
authors.initials: NB
authors.lastname: Parikh
authors.forename: Jasmine H
authors.initials: JH
authors.lastname: Francis
authors.forename: Robert A
authors.initials: RA
authors.lastname: Latkany
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002983:Clinical Competence / Q000592:standards*; D015352:Dry Eye Syndromes / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery; D009885:Ophthalmology / Q000193:education; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012826:Silicone Elastomers; D055815:Young Adult
chemical_list: D012826:Silicone Elastomers