title: Effects of preoperative punctal plug treatment on visual function and wound healing in laser epithelial keratomileusis.
abstract: OBJECTIVE
  To evaluate the effect of preoperative punctal plug treatment on early postoperative visual function and wound healing after laser epithelial keratomileusis (LASEK).
  
  
  METHODS
  Punctal plugs were implanted in 188 eyes from 95 patients (plug group; 41 men, 54 women; mean age 30.8 ± 6.6 years) before undergoing LASEK. Punctal plugs were inserted into both the superior and inferior puncta. Wound healing, visual acuity, and haze score after surgery were compared in 175 eyes of 88 age- and sex-matched control patients without punctal plug treatment (non-plug group; 43 men, 45 women; mean age 30.3 ± 8.0 years).
  
  
  RESULTS
  One week after LASEK, the mean fluorescein score in the plug group was significantly lower than the non-plug group (P<.0001). One week after surgery, uncorrected distance visual acuity (UDVA) of 20/20 or better was achieved in 82% and 53% of plug and non-plug patients, respectively. Compared with the non-plug group, better mean UDVA was seen in the plug group 7 days after surgery (non-plug group, 0.02 ± 0.17; plug group, -0.06 ± 0.13; P<.0001). Incidence of haze after LASEK was higher in the non-plug group (7.4%) compared with the plug group (1.6%) (P=.014).
  
  
  CONCLUSIONS
  Preoperative punctal plug treatment prior to LASEK promoted corneal epithelial wound healing and was associated with better visual acuity in the early postoperative period.
authors.affiliation: Nagoya Eye Clnic, Atsuta-ku, Nagoya, Japan. tkojkoj@mac.com
authors.forename: Takashi
authors.initials: T
authors.lastname: Kojima
authors.forename: Tamaki
authors.initials: T
authors.lastname: Watabe
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Nakamura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ichikawa
authors.forename: Yuya
authors.initials: Y
authors.lastname: Satoh
mesh_terms: D000328:Adult; D019573:Epithelium, Corneal / Q000502:physiology; D005143:Eyelids / Q000601:surgery; D005260:Female; D006801:Humans; D049008:Keratectomy, Subepithelial, Laser-Assisted; D007765:Lacrimal Apparatus / Q000601:surgery*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery; D011300:Preoperative Care; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D013666:Tears / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology*; D014945:Wound Healing / Q000502:physiology*