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Upper punctal occlusion increases visual function in patients with dry eye
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Upper punctal plug occlusion improved functional visual acuity in patients with dry eye due to short tear breakup time, a study found.
“Short [breakup time] type of dry eye has been reported to be associated with dry eye symptoms such as eye fatigue, discomfort and heaviness despite a normal tear volume and absence of corneal epithelial damage,” the study authors said.
The prospective, randomized study included 43 eyes of 43 patients with dry eye and short tear breakup time who underwent punctal plug occlusion. Nineteen eyes had upper punctal occlusion, and 24 eyes had lower punctal occlusion. Mean patient age was 55.8 years.
Patients underwent implantation of the Super Flex plug (Eagle Vision).
Investigators performed tear function and ocular surface evaluation before occlusion and 1 month after treatment. They used the FVA Measurement System (Nidek) to assess changes in continuous visual acuity over time; functional visual acuity was denoted in logMAR values. Visual maintenance ratio was also assessed.
A questionnaire was used to gauge patient satisfaction with visual outcomes.
Study results showed no significant between-group differences in central breakup time and peripheral breakup time.
Mean fluorescein staining scores, central breakup time and peripheral breakup time improved significantly in both groups (P < .05).
Mean visual maintenance ratio scores improved significantly in the upper punctal occlusion group (P < .05) but not in the lower punctal occlusion group.
Conventional logMAR visual acuity changed insignificantly in both groups after occlusion. However, mean functional visual acuity scores improved significantly in the upper occlusion group (P < .05).
Both groups had similar visual satisfaction scores, the authors said.
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