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Punctal plug

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136:. Before the cauterization, the surgeon tests for the effectiveness of the local sedation. Depending upon the type and depth of the cauterization, it is effective for a few months to a few years, by which time the puncta can possibly regrow and reopen. In this case, cauterization can be repeated. It initially offers complete closure of the duct. It also obviates the need for a punctal plug. It is performed for one puncta per appointment. Depending on the need, it can eventually be done for all four puncta. 103:
sought to assess the safety and efficacy of punctal plugs for the management of dry eye. The review included eighteen studies, testing punctal plugs of different materials, and comparing them to other treatments for dry eye. Overall there were mixed results; punctal plugs did not show consistent
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Some plugs are made of thermally reactive material. Some of these are inserted into the punctum as a liquid, and then harden and conform to the individual's drainage system. Others start out rigid and become soft and flexible, adapting to the individual's punctal size after they are inserted.
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Cauterization can result in temporary redness for a few hours which is caused by the avoidable use of a protective cover over the eye. Any lasting sensitivity as a result of this cover can be reversed using short-term use of steroid eye drops such as those containing
72:. These are available in various sizes. For maximum effectiveness, the largest size that fits should be used. These are more effective than collagen plugs. They can sometimes become loose and fall out, in which case they can be replaced. 104:
improvement of dry eye symptoms compared to the comparison group at follow-up. There was little evidence of differences between silicone and collagen or acrylic punctal plugs. Punctal plugs may be more effective than oral
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The risks of punctal plugs are fairly small. There is a risk of eye irritation, excessive tearing (lacrimation), and, in rare cases, infection.
200: 108:, but may be less effective than artificial tears. Some adverse outcomes from participants included spontaneous plug loss, 362: 208: 367: 87:
A large silicone plug can cause slight pain upon blinking after insertion. This discomfort may stop within a week.
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and are dissolvable. This is to ascertain that permanent ones will not cause excessive tearing (lacrimation).
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to block the duct. This prevents the drainage of liquid from the eye. They are used to treat
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If punctal plugs are at least partly effective, thermal, electric or radiofrequency (RF)
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A temporary punctal occlusion can be inserted and tried first. These are made of
322: 141: 105: 133: 112:, ocular irritation, foreign body sensation, and local inflammatory reaction. 234: 40: 303: 157: 69: 62: 124:
of puncti can be performed with local sedation. RF cauterization is an
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are usually still required after punctal plug insertion.
224: 222: 128:office procedure that can be performed by an 8: 68:Permanent punctal plugs are usually made of 293: 348:Punctal plugs and Intracanalicular plugs 270:"Punctal occlusion for dry eye syndrome" 263: 261: 259: 257: 194: 192: 190: 188: 186: 182: 16:Medical device to block the tear ducts 7: 268:Ervin AM, Law A, Pucker AD (2017). 199:Michelle Meadows (May–June 2005). 14: 209:U.S. Food and Drug Administration 286:10.1002/14651858.CD006775.pub3 1: 230:"Keratoconjunctivitis, Sicca" 156:for management/treatment of 389: 274:Cochrane Database Syst Rev 35:that is inserted into the 172:, i.e. widening of puncta 148:Other indications for use 201:"Dealing with Dry Eye" 101:Cochrane Collaboration 215:on February 23, 2008. 205:FDA Consumer Magazine 132:eye surgeon using a 363:Implants (medicine) 368:Medical equipment 97:systematic review 380: 335: 334: 332: 331: 314: 308: 307: 297: 265: 252: 251: 249: 247: 242:January 27, 2010 226: 217: 216: 211:. Archived from 196: 154:Sjögren syndrome 51:Artificial tears 23:, also known as 388: 387: 383: 382: 381: 379: 378: 377: 353: 352: 344: 339: 338: 329: 327: 316: 315: 311: 280:(6): CD006775. 267: 266: 255: 245: 243: 228: 227: 220: 198: 197: 184: 179: 166: 150: 118: 93: 82: 59: 39:(puncta) of an 17: 12: 11: 5: 386: 384: 376: 375: 370: 365: 355: 354: 351: 350: 343: 342:External links 340: 337: 336: 309: 253: 218: 181: 180: 178: 175: 174: 173: 165: 162: 161: 160: 149: 146: 126:electrosurgery 117: 114: 92: 89: 81: 78: 58: 55: 33:medical device 25:tear duct plug 15: 13: 10: 9: 6: 4: 3: 2: 385: 374: 373:Ophthalmology 371: 369: 366: 364: 361: 360: 358: 349: 346: 345: 341: 325: 324: 319: 313: 310: 305: 301: 296: 291: 287: 283: 279: 275: 271: 264: 262: 260: 258: 254: 241: 237: 236: 231: 225: 223: 219: 214: 210: 206: 202: 195: 193: 191: 189: 187: 183: 176: 171: 168: 167: 163: 159: 155: 152: 151: 147: 145: 143: 137: 135: 131: 127: 123: 122:cauterization 115: 113: 111: 107: 102: 98: 90: 88: 85: 79: 77: 73: 71: 66: 64: 56: 54: 52: 48: 46: 42: 38: 34: 31:, is a small 30: 29:lacrimal plug 26: 22: 328:. Retrieved 321: 312: 277: 273: 246:September 3, 244:. Retrieved 233: 213:the original 204: 170:Punctoplasty 138: 130:oculoplastic 119: 116:Alternatives 94: 86: 83: 74: 67: 60: 49: 28: 24: 21:punctal plug 20: 18: 323:Mayo Clinic 240:WebMD, Inc. 142:loteprednol 106:pilocarpine 357:Categories 330:2006-11-17 318:"Dry eyes" 177:References 134:hyfrecator 235:eMedicine 37:tear duct 304:28649802 164:See also 158:dry eyes 110:epiphora 91:Efficacy 70:silicone 63:collagen 295:5568656 99:by the 45:dry eye 302:  292:  80:Risks 57:Types 300:PMID 278:2017 248:2010 290:PMC 282:doi 41:eye 27:or 359:: 320:. 298:. 288:. 276:. 272:. 256:^ 238:. 232:. 221:^ 207:. 203:. 185:^ 144:. 95:A 47:. 19:A 333:. 306:. 284:: 250:.

Index

medical device
tear duct
eye
dry eye
Artificial tears
collagen
silicone
systematic review
Cochrane Collaboration
pilocarpine
epiphora
cauterization
electrosurgery
oculoplastic
hyfrecator
loteprednol
Sjögren syndrome
dry eyes
Punctoplasty





"Dealing with Dry Eye"
U.S. Food and Drug Administration
the original


"Keratoconjunctivitis, Sicca"

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