Lacrimal Puntual Plugs in Dry Eye Treatment

Abstract

Dry eye is a common condition that has a major impact on patients' quality of life. This lacrimal dysfunction syndrome is a multifactorial condition, arising from tear deficiency or excessive tear evaporation. Mild cases are treated with eye drops and lubricating gels. In patients with moderate dry eye syndrome with aqueous deficiency, occlusion of the lacrimal drainage system is considered. This treatment can be applied by placing plugs in the lacrimal puncta or canaliculus. Permanent plugs are made of silicone or acrylic polymer, and soluble plugs are made of collagen or synthetic material. They allow complete occlusion of the lacrimal puncta, are visible in the slit lamp and are easily removable. Their purpose is to prolong the presence of tears by preventing their exit through the lacrimal puncta. They present a low risk of migration into the nasolacrimal duct, but a high risk of loss by extrusion. Several designs have been developed to increase their efficacy and reduce their complications. A search of the scientific literature was carried out with the aim of describing the current context of puntual plugs in dry eye disease, in relation to their history, characteristics, classification, indications, requirements to perform the procedure, adverse effects, complications, removal and scientific evidence; which will serve as an update for our staff. It has been demonstrated that the plugs improve tear film quality, visual acuity and quality of life in patients suffering from dry eye condition.