title: Two-year outcome of partial lacrimal punctal occlusion in the management of dry eye related to Sjögren syndrome.
abstract: OBJECTIVE
  To analyze the influence of thermal partial punctal occlusion on the ocular surface of dry eye related to Sjögren syndrome.
  
  
  METHODS
  Thirty-seven eyes of 19 patients (3 male and 16 female; 49.11 ± 14.33 years old) with keratoconjunctivitis sicca were enrolled in this study. Superior and inferior partial occlusion were performed in both eyes under topical anesthesia using thermal cautery with a sterile tip to obtain lacrimal punctum smaller than 0.5 mm. Schirmer I, break-up-time, diameter of lacrimal puncta, corneal fluorescein, and rose Bengal staining scores were analyzed before and after 24 weeks and after 24 months of the procedure. All measurements were performed under controlled climate.
  
  
  RESULTS
  The average lacrimal punctum diameter before the procedure was 0.65 ± 0.134 mm. All lacrimal puncta were successfully reduced to less than 0.5 mm after 4 weeks of the procedure. The average Schirmer I test values improved statistically after 24 weeks and maintained stable after 24 months. Average break-up-time, rose Bengal, and fluorescein staining score values improved statistically after 24 weeks and improved even more after 24 months. Average Schirmer I test, break-up-time, rose Bengal, and fluorescein staining scores showed significant improvement (p < 0.0001) after 24 months of partial thermal punctal occlusion.
  
  
  CONCLUSIONS
  Our study showed that reducing the punctum diameter to 0.5 mm can improve vital staining scores, break-up-time, and Schirmer I test in dry eye related to Sjögren syndrome.
authors: Department of Ophthalmology, Hospital das Clínicas of University of São Paulo, Brazil.
authors: Ricardo
authors: R
authors: Holzchuh
authors: Marcos Bottene
authors: MB
authors: Villa Albers
authors: Tammy Hentona
authors: TH
authors: Osaki
authors: Thais Zamudio
authors: TZ
authors: Igami
authors: Ruth Miyuki
authors: RM
authors: Santo
authors: Newton
authors: N
authors: Kara-Jose
authors: Nilo
authors: N
authors: Holzchuh
authors: Richard Y
authors: RY
authors: Hida