title: Efficacy of punctal occlusion in management of dry eyes after laser in situ keratomileusis for myopia.
abstract: OBJECTIVE
  To evaluate the effect of punctal plug use in preventing dry eye after laser in situ keratomileusis (LASIK).
  
  
  METHODS
  A randomized clinical trial at a tertiary eye care center, Riyadh, Saudi Arabia. Participants underwent LASIK for myopia in both eyes and a lower punctal occlusion in one eye only while the other eye served as control. Both eyes received the same postoperative medications except for lubricant duration (subject eye: four times per day for one week; control eye: four times per day for 6 months). Participants were evaluated at 1 week, 2, and 6 months after surgery for signs and symptoms of dry eye. The main outcome measures were visual acuity; ocular surface parameters; and Ocular Surface Disease Index questionnaire.
  
  
  RESULTS
  Seventy-eight eyes of 39 patients were included in this study. The Ocular Surface Disease Index scores of eyes with punctal plugs were better at all follow-up visits, and the differences between both eyes were statistically significant (1 week, p < 0.0001; 2 months, p < 0.0001; 6 months, p = 0.008). At the final follow-up visit, the percentage of normal eyes was higher in eyes with punctal plugs for all ocular surface parameters (Schirmer 1 test, 94.9%; tear breakup time, 77.8%; punctate epithelial keratitis score, 71.8%) compared to eyes without occlusion (Schirmer 1 test, 92.3%; tear breakup time, 58.3%; punctate epithelial keratitis score, 53.8%); however, such differences were not statistically significant.
  
  
  CONCLUSIONS
  Punctal plug insertion after LASIK surgeries may minimize the need for frequent lubricant application and hence improve patient satisfaction.
authors.affiliation: Department of Ophthalmology, College of Medicine, King Saud University , Riyadh , Kingdom of Saudi Arabia .
authors.forename: Abdullah M
authors.initials: AM
authors.lastname: Alfawaz
authors.forename: Saeed
authors.initials: S
authors.lastname: Algehedan
authors.forename: Sabah S
authors.initials: SS
authors.lastname: Jastaneiah
authors.forename: Samir
authors.initials: S
authors.lastname: Al-Mansouri
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mousa
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al-Assiri
mesh_terms: D000328:Adult; D003315:Cornea / Q000601:surgery*; D015352:Dry Eye Syndromes / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D007765:Lacrimal Apparatus / Q000601:surgery*; D008297:Male; D009216:Myopia / Q000601:surgery*; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D012828:Silicones; D013525:Surgical Instruments; D013666:Tears; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D009883:Ophthalmic Solutions; D012828:Silicones