title: Punctal plugs versus artificial tears for treating primary Sjögren's syndrome with keratoconjunctivitis SICCA: a comparative observation of their effects on visual function.
abstract: To compare the effects of treatment with punctal plugs versus artificial tears on visual function for primary Sjögren's syndrome with dry eye. Forty-two eyes of 42 patients with primary Sjögren's syndrome were enrolled and were allocated randomly into artificial tears (AT) group and punctal plugs (PP) group. Ocular Surface Disease Index (OSDI) was used, and fluorescent staining for tear film break-up time (BUT), the Schirmer test I (STI) and contrast sensitivity was performed before treatment and was repeated 3 months after treatment. A follow-up of 3 months was achieved in 40 eyes of 40 patients, including 19 eyes in artificial tears group and 21 eyes in punctal plugs group. Statistically significant improvements were observed in the OSDI scores (AT: 52.6 ± 5.7, 15.9 ± 4.2; PP: 55.8 ± 4.9, 15.1 ± 4.2), corneal fluorescein staining scores (AT: 2.60 ± 1.76, 0.30 ± 0.57; PP: 1.91 ± 1.60, 0.09 ± 0.29), STI (AT: 3.85 ± 2.03, 8.95 ± 2.72; PP: 3.36 ± 1.62, 11.41 ± 2.65), and BUT (AT: 2.60 ± 1.39, 6.00 ± 1.81; PP: 2.27 ± 1.12, 7.82 ± 1.84) after treatment compared to those of pre-treatment. The values of STI (AT: 5.10 ± 1.80; PP: 8.05 ± 1.53) and BUT (AT: 3.40 ± 1.31; PP: 5.68 ± 1.13) in punctal plugs group were significantly more improved than those in the artificial tears group. The medium- and high-level frequencies contrast sensitivities were greatly improved in simulated daylight, night, and glare disability conditions after treatment with artificial tears and punctal plugs. However, the changes in contrast sensitivity did not significantly differ between groups. Both artificial tears and punctal plugs relieved dry eye symptoms, repaired corneal lesions, enhanced tear film stability, and improved contrast sensitivity. Punctal plugs could improve tear film stability and elongate the BUT better than artificial tears.
authors: Department of Ophthalmology, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
authors: Weiqiang
authors: W
authors: Qiu
authors: Ziyuan
authors: Z
authors: Liu
authors: Mingxin
authors: M
authors: Ao
authors: Xuemin
authors: X
authors: Li
authors: Wei
authors: W
authors: Wang
mesh_terms: D000328:Adult; D015350:Contrast Sensitivity / Q000502:physiology; D005260:Female; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000503:physiopathology / Q000628:therapy*; D007765:Lacrimal Apparatus / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D019736:Prostheses and Implants; D012859:Sjogren's Syndrome / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D009883:Ophthalmic Solutions
references: Cornea. 1998 Jul;17(4):376-9
references: 9676908
references: CLAO J. 1989 Jul-Sep;15(3):216-8
references: 2476258
references: Clin Ophthalmol. 2009;3:501-6
references: 19789659
references: Am J Ophthalmol. 2003 May;135(5):704-5
references: 12719079
references: Rheumatol Int. 2011 Dec;31(12):1567-70
references: 20490802
references: Ophthalmology. 2000 Sep;107(9):1754-60
references: 10964840
references: Br J Ophthalmol. 1992 Mar;76(3):157-8
references: 1540559
references: Clin Ophthalmol. 2009;3:405-12
references: 19688028
references: Arch Ophthalmol. 2000 May;118(5):615-21
references: 10815152
references: Am J Ophthalmol. 2001 Jul;132(1):1-7
references: 11438046
references: Ophthalmology. 2002 Oct;109(10):1934-40
references: 12359618
references: Br J Ophthalmol. 1998 Jun;82(6):666-75
references: 9797670
references: Invest Ophthalmol Vis Sci. 1980 Apr;19(4):401-6
references: 7358491
references: Ophthalmology. 1999 May;106(5):939-43
references: 10328393
references: Cornea. 1998 Jan;17(1):38-56
references: 9436879
references: Ann Rheum Dis. 2002 Jun;61(6):554-8
references: 12006334
references: Graefes Arch Clin Exp Ophthalmol. 1993 Oct;231(10):577-9
references: 8224932