Effect of Punctal Occlusion on Tear Menisci in Symptomatic Contact Lens Wearers

Li, Ming; Wang, Jianhua; Shen, Meixiao; Cui, Lele; Tao, Aizhu; Zhao, Chen; Ge, Lili; Liu, Fan

doi:10.1097/ico.0b013e31823f8d9e

Cited by 11 publications

(4 citation statements)

References 40 publications

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“…TMH measurement has been used to assess the effect of punctal plug insertion. Several publications 6,14,15 demonstrated that TMH increased immediately after plug insertion, with results very similar to our study. The immediate increase in TMH after punctal occlusion showed tear secretion still remaining in many patients, even those with severe ADDE, but tear drainage had a deleterious effect in these cases.…”

Section: Discussionsupporting

confidence: 92%

“…For severe dry eye, inferior and superior punctal occlusion has better efficacy than simple inferior occlusion. 6 A meta-analysis of 18 studies 7 concluded that silicone plugs could reduce symptoms quickly after insertion in patients with severe dry eye disease but with low evidence. However, some authors have reported spontaneous loss of plugs in one third of patients within 1 month after insertion, along with complications such as excessive tearing, increased inflammation of the ocular surface, plug migration, canaliculitis, and pyogenic granuloma.…”

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confidence: 99%

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Immediate and Delayed Effects of Punctal Plug Insertion on Tear Meniscus Height in Severe Aqueous-Deficient Dry Eye

Hallali,

Guindolet,

Gabison

et al. 2024

Cornea

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Purpose: The aim of this study was to assess the immediate and delayed effects of tear punctal occlusion with punctal plugs on tear meniscus height (TMH) in severe aqueous-deficient dry eye (ADDE) disease. Methods: Consecutive patients with severe ADDE related to Sjögren syndrome or ocular graft-versus-host disease underwent inferior and superior occlusion with punctal plugs. TMH was measured using the LacryDiag ocular surface analyzer platform before, 10 minutes, and at least 1 month after punctal occlusion. The corneal fluorescein staining (CFS) score was graded with the Oxford scale (from 0 to 5). Ocular symptoms were graded with a visual analog scale (from 1 to 10). Results: We included 24 eyes of 24 patients (mean age 61 ± 9 years; mean follow-up 7 ± 5 months). The mean TMH was 0.19 ± 0.06 mm at baseline and increased significantly to 0.41 ± 0.13 mm (P < 0.001) and 0.46 ± 0.17 mm (P < 0.001) at 10 minutes after punctal plug insertion and at the end of follow-up, respectively. The median CFS score decreased from 3 ± 1 before plug insertion to 1 ± 2 at the end of follow-up (P < 0.001). Many patients (67%; n = 16) reported subjective improvement of symptoms. TMH was negatively correlated with the CFS score and visual analog scale score assessing symptoms. Conclusions: Upper and lower punctal occlusion increased TMH in patients with severe ADDE as soon as 10 minutes after plug insertion. TMH remained stable over time, which led to the relief of symptoms and reduced corneal staining.

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

Immediate and Delayed Effects of Punctal Plug Insertion on Tear Meniscus Height in Severe Aqueous-Deficient Dry Eye

Hallali,

Guindolet,

Gabison

et al. 2024

Cornea

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“…Li et al used ultrahigh resolution optical coherence tomography to see the effect of punctal occlusion on tear menisci in contact lens wearers with and without symptoms of dry eyes. Tear menisci increased transiently in both symptomatic and asymptomatic lens wearers and increased for a longer duration in symptomatic wearers [ 50 ]. A randomized controlled clinical trial evaluated the effect of punctal occlusion in dry eye contact lens wearers using a self-assessment questionnaire and evaluation of pre- and postlens tear film thickness.…”

Section: Methodsmentioning

confidence: 99%

Comprehensive Review of the Literature on Existing Punctal Plugs for the Management of Dry Eye Disease

Jehangir

Bever

Mahmood

et al. 2016

Journal of Ophthalmology

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Numerous designs of punctal and canalicular plugs are available on the market. This variety presents challenges to ophthalmologists when choosing punctal plugs for the management of various ocular conditions. The aim of this literature review is to provide a classification system for lacrimal occlusive devices based on their location and duration of action as well as to identify different characteristics of each one of them. We want to give a comprehensive overview on punctal and canalicular plugs including their manufacturing companies, indications, and complications that have been reported in various articles. PubMed and Google Scholar were used to identify articles written in English as well as few articles written in Japanese, Chinese, Slovak, and Spanish that had abstracts in English. Nine different companies that manufacture punctal and canalicular plugs were identified and their plugs were included in this review. Punctal and canalicular plugs are used in the management of various ocular conditions including dry eye disease and punctal stenosis as well as in ocular drug delivery. Although they are a relatively safe option, associated complications have been reported in the literature such as infection, allergic reaction, extrusion, and migration.

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“…UHR-OCT can perform a dynamic evaluation of contact lens movement with blinking and shifting gaze [42]. Soft contact lenses usually overlap 2 mm on the bulbar conjunctiva, but can displace further and overlap 4 to 5 mm onto the bulbar conjunctiva during blinking [43].…”

Section: Contact Lens Fittingmentioning

confidence: 99%

Corneal Microlayer Optical Tomography Review

Roongpoovapatr¹,

Cook²,

Eleiwa³

et al. 2019

A Practical Guide to Clinical Application of OCT in Ophthalmology

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Anterior segment ultra-high resolution OCT (UHR-OCT) uses a resolution of 1-4 μm to provide non-invasive imaging of the tear film and cornea. This new high definition imaging technology increases our understanding of normal structure and pathological changes in the cornea, and resolution has continued to improve over time. UHR-OCT is useful in the treatment of disease such as dry eye, subclinical keratoconus, keratoconus, and ocular surface pathology. It also aids clinicians in fitting contact lenses and screening tissue for corneal transplantation. In this review, we summarize applications of imaging the normal and pathologic ocular surface and cornea. Novel developments, such as the new-generation micro-OCT, Anterior segment OCT angiography and artificial intelligence have the potential to continue to increase our knowledge.

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Effect of Punctal Occlusion on Tear Menisci in Symptomatic Contact Lens Wearers

Abstract: Punctal occlusion transiently increased tear menisci in symptomatic and asymptomatic lens wearers, with a longer duration in the symptomatic group. For both symptomatic and asymptomatic lens wearers, the increased meniscus volume was associated with improved ocular comfort.

Cited by 11 publications

References 40 publications

Immediate and Delayed Effects of Punctal Plug Insertion on Tear Meniscus Height in Severe Aqueous-Deficient Dry Eye

Immediate and Delayed Effects of Punctal Plug Insertion on Tear Meniscus Height in Severe Aqueous-Deficient Dry Eye

Comprehensive Review of the Literature on Existing Punctal Plugs for the Management of Dry Eye Disease

Corneal Microlayer Optical Tomography Review

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