[Complications of punctum plug in the symptomatic treatment of dry eye].

Abstract

76 patients with dry eyes were treated by mechanical obstruction of lacrymal puncta. The sex ratio is: 62 females and 14 males. The age average was 55, ranging from 12 to 88. The etiologies were: Sjögren's syndrome: 16 cases (21%); filamentous kerato-conjonctivitis sicca: 12 cases (15%); anxiolytical and anti-depressant treatments: 10 cases (13%); complicated viral kerato-conjonctivitis: 4 cases (5%); post radiotherapy dry syndrome: 3 cases (4%); idiopathic and various etiologies: 31 cases (40%). The 149 plugs are completely made of hydrophobic silicone; 20 had a barb inclined on the neck axis. Insertion was achieved after tropical anesthesia in 90% of the cases. 121 plugs (81%) did not lead to any anatomical complication (the average duration remaining on time interval of implantation per plug was of 5 months). Functional tolerance depends on the quality of plug-punctum adjustment. Plug protrusion is the main cause of intolerance and disappearance. The complications were: rupture of punctum during dilation: 1%; suppurative canaliculitis: 1.3%; disappearance: 16%; epiphora: 22%. No intra-canalicular migration was observed. We check canalicular permeability in 26 cases, after loss or removal: che was normal 23 times (average time-interval: 5 months). We had 3 cases of canalicular stenosis after 4 months, 5 months and 18 months of intubation.