Effect of Collagen Punctal Occlusion on Tear Stability and Volume

Abstract

When the patient has dry eye symptoms, the clinician can apply several techniques to, evaluate tear status, the likely cause of symptoms, decide on appropriate therapy and monitor the progress and reaction of the eye. When the dry eye is the result of insufficient lacrimal output coupled with an abnormally high evaporation rate, the clinician can attempt to retain moisture at the ocular surface by blocking the lacrimal canaliculi. In this endeavour, occlusion of the inferior and/or superior punctum lacrimale has been applied for many years ^1,2. Permanent occlusion can be produced by cautery. However, reversible occlusion is preferable and this can be achieved by inserting either a plastic or silicone plug of appropriate design. More useful arc intracanalicular implants manufactured out of processed collagen which have the property of self-dissolulion. They can be used as temporary ‘plugs’ which will help the clinician decide whether or not a more permanent occlusion is the better option. In the literature there are several anecdotal reports praising the punctal plug and reporting on patient satisfaction. There are very few studies reporting on objective changes in the tear film properties as a consequence of punctal or canalicular occlusion.