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Punctal and canalicular plugs are widely used for both temporary and permanent occlusion of the lacrimal puncta in dry eyes. There are many designs and materials available on the market. While their efficacy in improving dry eye symptoms is widely proven, the gamut of complications associated with these devices have never been subject to a general review, although there are numerous case series in the literature associated with one particular device. This review aims to examine the track record of a variety of plugs currently in use, to review the management of complications, and propose strategies for both the prevention of these complications and their treatment. [ABSTRACT FROM AUTHOR]

Background: The use of punctal plugs in the treatment of dry eyes is well established. Anophthalmic patients have less tears in the anophthalmic socket in comparison to their normal side, due to an absent corneal reflex (Lee & Elsie, 1981a,b). Many of those patients complain of dry eye symptoms, even when they are treated with tear replacement therapy. The authors wished to examine whether they could improve their dry socket complaints with punctal plugs. Purpose: To evaluate the clinical efficacy and tolerability of punctal plug (Smart Plugs®) insertion in anophthalmic patients with symptoms of dry eye. Patients and methods: Interventional case series. Fifteen anophthalmic patients with dry eye symptoms, a Schirmer test of less than 3 mm and an open lacrimal passage were examined before and after insertion of punctal plugs. The patients were asked for their subjective evaluation of the treatment and were examined to evaluate the change. Schirmer tests were compared. Bacterial cultures were taken at both visits. Results: Schirmer results of less than 3 mm in the anophthalmic socket were obtained in 75% of patients with dry eyes symptoms; 87% of patients in whom punctal plugs were inserted reported an improvement in dry eye sensation. More than half of the patients demonstrated less discharge (p ≤ 0.05). Schirmer tests improved from 1.4 mm to 1.9 mm (p ≤ 0.05). Patients with a Schirmer outcome of 2 mm or more tended to have less pathogenic bacterial cultures (p = 0.11). Conclusion: Punctal plugs improve the symptoms and signs of dry socket. Punctal plugs seem to reduce the pathogenic bacterial growth in the anophthalmic socket. [ABSTRACT FROM AUTHOR]

Purpose : To report two cases of pyogenic granuloma following silicone punctal plugs. Methods : Interventional case reports. Results : The authors report two cases of pyogenic granuloma secondary to silicone punctal plugs and their lacrimal sequelae following surgical removal in one case and conservative treatment with removal of the plug alone in another. The former case developed no lacrimal sequelae while the second case developed punctal scarring. Spontaneous loss of plugs was common to both the cases. Conclusions : Patients with punctal plugs should be informed about plug-related problems and encouraged to report them. [ABSTRACT FROM AUTHOR]