Changes of Ocular Surface after Silicone Punctal Plug Insertion in Patients with Dry Eye Syndrome

Oh, Han Jin; Yoon, Kyung Chul; Park, Yeoung Geol

Abstract

PURPOSE
To evaluate the changes in tear film and the ocular surface before and after punctal occlusion by silicone punctal plug insertion in dry eye patients. METHODS: Twenty-four eyes of 19 patients with dry eye were included. We performed corneal sensitivity test, tear film break-up time (BUT), basal tear secretion test (BST), fluorescein staining, tear clearance test (Tcr), and conjunctival impression cytology and then compared the measurements before and after punctal occlusion. RESULTS: Before silicone pucntal plug insertion corneal sensitivity, BUT, BST, fluorescein staining score, and Tcr were: 52.50+/-6.55 mm, 4.47+/-1.33 sec, 4.07+/-1.86 mm, 4.74+/-3.21 and 3.83+/-1.62, respectively. The grade of conjunctival squamous metaplasia was 2.45+/-1.26, and goblet cell density was 131.82+/-125.53 cells/mm2 before punctal occlusion. After punctal plug insertion corneal sensitivity was 58.13+/-3.72 mm (p=0.015), BUT was 6.76+/-2.59 sec (p<0.01), BST was 5.57+/-3.32 mm (p=0.161), fluorescein staining score was 1.74+/-2.13 (p<0.01) and Tcr was 4.50+/-1.29 (p=0.198). The degree of conjunctival squamous metaplasia was 1.12+/-0.83 (p=0.019) and goblet cell density was 206.67+/-155.78 cells/mm2 (p=0.229) after punctal plug insertion. CONCLUSIONS: The tear films and ocular surface changes after punctal plug insertion in dry eye patients include increased corneal sensitivity, improved quality of tear films and decreased conjunctival squamous metaplasia.