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Punctal Plugs and Lasik

Plugs to block the canals that drain tears are a common technique to resolve dry eye related to Lasik or Bladeless Lasik.


Illustrated diagram of the punctum canals inset into an image of an eye.  
Punctal plugs can help resolve Lasik induced temporary dry eye by restricting tears from draining into the sinus through the punctum.  
   

Punctal occlusion with punctal plugs is a method to block the intracanalicular punctum with temporary or permanent plugs. When properly fitted, punctal plugs are not felt by the patient or visible to others.

Common After Lasik

It is relatively common for conventional or wavefront custom Lasik, Bladeless Lasik patients to receive punctal plugs. Punctal plugs help keep the eyes hydrated by blocking the drainage of the tears through the nasolacrimal duct into the sinus system.

Punctal plugs come in many styles and sizes. A comfortable fit should be available for all.

Temporary or Permanent

A Lasik patient may be provided with temporary punctal plugs. After a predetermined number of days, they dissolve. If relief from dry eye symptoms is provided during those few days, then semi-permanent plugs may be inserted.

It is also possible to have these tear drainage ducts permanently occluded with cauterization, but that is useful primarily if the dry eye is chronic and expected to be long-term. The semi-permanent plugs are normally comfortable and successful, and Lasik-induced dry eye normally eventually resolves.

Headache Sinus Pain

Punctal plugs may help keep tears on the eye, but the sudden lack of moisture into the sinus can cause irritation that may present as headaches and pain behind the eye. See our article about Lasik eye strain. These symptoms are often initially attributed to dry eye. Verification if punctal plugs are required may be helpful. See also Lasik dry eye treatment.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

Personalized Answers

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.


Recent Punctal Occlusion Medical Journal Articles...

Related Articles

Clinical Guidelines for Management of Dry Eye Associated with Sjögren Disease.

Ocul Surf. 2015 Apr;13(2):118-132

Authors: Foulks GN, Forstot SL, Donshik PC, Forstot JZ, Goldstein MH, Lemp MA, Nelson JD, Nichols KK, Pflugfelder SC, Tanzer JM, Asbell P, Hammitt K, Jacobs DS

Abstract
PURPOSE: To provide a consensus clinical guideline for management of dry eye disease associated with Sjögren disease by evaluating published treatments and recommending management options.
DESIGN: Consensus panel evaluation of reported treatments for dry eye disease.
METHODS: Using the 2007 Report of the International Workshop on Dry Eye (DEWS) as a starting point, a panel of eye care providers and consultants evaluated peer-reviewed publications and developed recommendations for evaluation and management of dry eye disease associated with Sjögren disease. Publications were graded according to the American Academy of Ophthalmology Preferred Practice Pattern guidelines for level of evidence. Strength of recommendation was according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines.
RESULTS: The recommendations of the panel are briefly summarized herein. Evaluation should include symptoms of both discomfort and visual disturbance as well as determination of the relative contribution of aqueous production deficiency and evaporative loss of tear volume. Objective parameters of tear film stability, tear osmolarity, degree of lid margin disease, and ocular surface damage should be used to stage severity of dry eye disease to assist in selecting appropriate treatment options. Patient education with regard to the nature of the problem, aggravating factors, and goals of treatment is critical to successful management. Tear supplementation and stabilization, control of inflammation of the lacrimal glands and ocular surface, and possible stimulation of tear production are treatment options that are used according to the character and severity of dry eye disease.
SUMMARY: Management guidelines for dry eye associated with Sjögren's disease are presented.

PMID: 25881996 [PubMed - as supplied by publisher]

 


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