Lacrimal occlusion with punctal or canalicular plugs have been used to treat dry eye disease for more than 40 years. Indeed, punctal plugs constitute a safe and effective tool to retain the natural tear film and prolong the effect of tear substitutes. A wide variety of plugs is available, differing in their design, location (punctal versus canalicular) and their resorbability. There indications have increasingly broadened, and they are now one of the treatment options for numerous ocular surface diseases. Current research focuses on using punctal plugs for extended delivery of drugs to the ocular surface. This review addresses physiology of lacrimal drainage, available models of punctal plugs, their indications, practical details of prescribing and placing punctal and canalicular plugs, and possible complications.
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Evaluation of the Microbiology of Removed Punctal Plugs and Intracanalicular Devices.
Eye Contact Lens
November 2024
Department of Ophthalmology (J.J.M., N.E., W.C.F., A.M.F.), University of North Carolina, Chapel Hill, NC; Department of Ophthalmology (J.J.M.), University of Auckland, Auckland, New Zealand; Tricore Reference Laboratories (K.C.), Albuquerque, NM; Brooke Army Medical Center (E.A.), San Antonio, TX; Medical College of Wisconsin Department of Ophthalmology (N.E.), Milwaukee, WI; Campbell University School of Medicine (W.C.F.), Lillington, NC; Department of Pathology-Laboratory Medicine (P.G.), University of North Carolina School of Medicine, Chapel Hill, NC; and Department of Ophthalmology (A.M.F.), Duke University, Durham, NC.
Article Synopsis
- The study aimed to analyze the types of microorganisms that colonize punctal plugs and intracanalicular stents used for tear insufficiency and eye surgeries.
- The researchers collected and cultured 181 devices from participants and found that over half (54%) were culture positive, revealing a variety of microorganisms, mainly skin and upper respiratory flora.
- No clinical infections were reported, but the findings suggest that these ocular devices can harbor potentially harmful bacteria, indicating a need for monitoring.
Canalicular Cyst After Punctal Plug Insertion.
J Craniofac Surg
October 2024
Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine.
Article Synopsis
- - A 73-year-old male developed a canalicular cyst on his right lower eyelid after having absorbable punctal plugs inserted for dry eye syndrome 8 years earlier.
- - The cyst was found on the medial side of the eyelid, causing ectropion but showing no signs of inflammation; surgical incision and drainage reduced its size.
- - Imaging studies indicated cystic dilation and obstruction in the canaliculus, highlighting that canalicular cysts should be considered when similar patients present with masses in the eye area.
Effectiveness and safety of a novel crosslinked hyaluronate canalicular gel occlusive device for dry eye.
J Cataract Refract Surg
October 2024
From Packer Research Associates, Inc., Fort Collins, Colorado (Packer); Minnesota Eye Consultants, Bloomington, Minnesota (Lindstrom); Vance Thompson Vision, Sioux Falls, South Dakota (Thompson); The New York Eye & Ear Infirmary, New York, New York, Icahn School of Medicine at Mt Sinai, New York, New York (Parekh); Triangle Eye Consultants, Raleigh, North Carolina (Gupta); Warrenville EyeCare and LASIK, Warrenville, Illinois (Nijm); New York University Medical Center, New York, New York (Donnenfeld).
Purpose: To evaluate the effectiveness and safety of a crosslinked hyaluronate (HA) canalicular filler (Lacrifill Canalicular Gel) compared with a commercially available hydrogel canalicular plug (Form Fit).
Setting: 5 sites in the United States.
Design: Prospective, multicenter, controlled, double-masked, randomized 2:1 (filler:plug).
A major review on punctal stenosis: Part II: Updated therapeutic interventions, complications, and outcomes.
Surv Ophthalmol
September 2024
Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India. Electronic address:
We continue our review of on punctal stenosis by providing a detailed discussion of management modalities, their complications, and outcomes. There is a significant change in the understanding of punctal and peripunctal anatomy, puncto-canalicular junction, and the lacrimal pump mechanisms. While the snip punctoplasty procedures are still practiced, there is an increasing trend toward nonincisional procedures.
View Article and Find Full Text PDFQuality of life improvement in dry eye patients after intense pulsed light therapy compared to punctal plugs.
Oman J Ophthalmol
February 2024
Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Purpose: The purpose of the study was to evaluate the quality of life (QOL) improvement in evaporative dry eye patients after treatment with intense pulsed light (IPL) therapy compared to punctal plug insertion.
Methods: A prospective comparative interventional study included 30 patients with moderate-to-severe evaporative dry eye. Patients' QOL affection before and after treatment was assessed by the Ocular Surface Disease Index (OSDI) questionnaire.
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