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Ocular inflammation not relieved by punctal plugs, researchers say
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While insertion of punctal plugs had minimal effect on tear cytokines and matrix metalloproteinase levels, punctal plug occlusion provided symptomatic relief and reduced fluorescein staining in all except the inferior zone, according to researchers in The Ocular Surface.
A total of 29 moderate dry eye patients received nonabsorbable punctal plugs in the lower punctum of both eyes.
At baseline, global symptoms score was 53.8, Schirmer I test score was 5.1 mm and tear film break-up (TFBUT) time was 2.2 seconds. After 3 weeks, punctal occlusion significantly reduced global irritation score and decreased fluorescein staining in all zones except the inferior zone, according to researchers.
No statistically significant improvements were seen at week 1 or week 3 compared to baseline in either Schirmer I scores or TFBUT. At week 3, researchers found cytokines and matrix metalloproteinase (MMP-9) levels were similar to baseline levels.
Further analysis revealed that patients with low baseline Schirmer I test scores had elevated levels of tear cytokines and MMP-9 compared with those with higher baseline Schirmer I test scores.
“The lack of significant changes in cytokine levels and inferior corneal staining following punctal occlusion observed in this study suggests that patients with dry eye may benefit from earlier treatment or concurrent instillation of anti-inflammatory agents with punctal plugs for management of their disease,” the researchers wrote. – by Abigail Sutton
Disclosure: Tong reported no relevant financial disclosures. Please see the full study for a list of all remaining authors’ financial disclosures.
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