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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 All-Laser Lasik.


punctum
Punctal plugs can help resolve Lasik induced temporary dry eye by restricting tears from draining into the sinus through the punctum.

 

Punctal occlusion 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, All-Laser 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.

If you are ready to choose a doctor to be evaluated for conventional or wavefront custom Lasik, All-Laser Lasik, PRKK, LASEK, Epi-Lasik, NearVision CK, RLE, or any refractive surgery procedure, we highly recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Laser Eye Surgery Doctor.

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


Current Punctal Plug Medical Journal News...

Postrefractive surgery dry eye.

Related Articles

Postrefractive surgery dry eye.

Curr Opin Ophthalmol. 2008 Jul;19(4):335-41

Authors: Quinto GG, Camacho W, Behrens A

PURPOSE OF REVIEW: To report the recently published literature on ocular surface changes after refractive surgery, as well as the outcomes of treatment modalities on postrefractive surgery dry eye. RECENT FINDINGS: Cyclosporine, the first US Food and Drug Administration approved agent to treat the underlying pathological mechanism of chronic dry eye, has demonstrated promising results in dry eye patients. Further, there may be an additive effect of topical cyclosporine and punctal occlusion. Femtosecond lasers for corneal flaps in laser in-situ keratomileusis seem to induce fewer signs and symptoms of dry eye and may be attributed to the creation of thinner flaps. SUMMARY: Dry eye is one of the most common complications after photorefractive keratectomy and laser in-situ keratomileusis. Keratorefractive surgery is known to cause damage to the corneal sensory nerves. Several studies have demonstrated a decrease in corneal sensation, tear secretion, and tear film stability several months after keratorefractive surgery. For patients with preoperative dry eye, the ocular surface must be treated accordingly prior to surgery.

PMID: 18545018 [PubMed - in process]

 

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Last updated Wednesday, July 02, 2008

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