PubMed · 16127813
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Michelle Meadows. Dealing with dry eye.. https://pubmed.ncbi.nlm.nih.gov/16127813/
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The etiology of dysfunctional tear syndrome ("dry eye") is multifactorial and complex. Recent evidence suggests an important role of androgens in regulating tear film secretion onto the ocular surface. In addition, inflammatory processes of the ocular surface seem to be the common final pathway of all chronic forms of dry eye. Novel concepts of pathogenesis and state-of-the-art diagnostic tools are discussed. In vivo confocal microscopy allows quantification of ocular surface inflammatory cells. This is of increasing importance for evaluation of anti-inflammatory treatments in dry eye patients.
PURPOSE: To evaluate the efficacy of a thermo sensitive punctum plug, the Smart Plug, in the treatment of dry eyes. DESIGN: Observational case-series study. METHODS: Eighteen eyes of 10 dry eye patients who previously failed conventional plug insertion were enrolled. Schirmer 1 test, vital staining scores, and tear clearance tests were performed before plug insertion, at 2 weeks, 1 month, and 3 months after insertion. RESULTS: Although Schirmer test values were not significantly different before and after plug insertion, the tear clearance rate considerably decreased (Before insertion: 14.8+/-11.4; After insertion: 8.2+/-6.6) (P<.05). Rose-Bengal and fluorescein scores improved significantly after plug insertion (Rose-Bengal: Before insertion: 6.4+/-2.0; After insertion: 3.3+/-1.6 points, Fluorescein: Before insertion: 4.8+/-2.3; After insertion: 2.1+/-1.3) (P<.05). No complications were observed. CONCLUSIONS: Smart Plug proved to be a safe and efficient option in the treatment of dry eye.
PURPOSE: To report a complication, not previously described, of the Medennium SmartPLUG, which is a new punctal plug with a novel design. METHODS: Two case reports are detailed, including clinical and pathologic photographs. RESULTS: Case 1 is a 58-year-old woman with Sjögren syndrome. Nearly 2 years following placement of a SmartPLUG in her right lower canaliculus, the patient presented with an erythematous, papillomatous growth overlying her punctum. Biopsy demonstrated pyogenic granuloma. Case 2 is a 62-year-old woman with dry eye. Exactly 2 years after a SmartPLUG was place in her right lower canaliculus, she also developed a pyogenic granuloma. After irrigation to remove the plug, the growth decreased in size. CONCLUSION: Pyogenic granuloma can develop as a late complication of the Medennium SmartPLUG punctum plug.