Efficacy, Retention, and Complications of Two Types of Silicone Punctal Plugs in Dry Eye Patients

Purpose: We analyzed the clinical efficacy, retention rates, and complications after inserting two types of silicone plugs in dry eye patients. Methods: The medical records of 73 patients (133 eyes) whose lacrimal puncta were occluded with the SuperEagle Punctum Plug (TM) (EagleVision, Denville, NJ, USA) or the Parasol Punctum Plug (TM) (Beaver-Visitec International, Inc. Waltham, MA, USA) were analyzed. Conventional indices for dry eye disease and tear meniscus height (TMH) using optical coherence tomography were used to determine the clinical efficacy. The overall retention rates and complications were investigated and those of each plug were compared between the two groups during the first 6 months after insertion. Results: The average age was 52.52 +/- 13.66 years (13-82 years). Group A included 79 eyes and group B included 54 eyes. TMH tended to increase after 6 months regardless of plug loss or removal due to complications. Schirmer I test value differences before and 6 months after plug insertion were positively correlated with the TMH differences in study subjects (p = 0.007). Plug loss was the most frequent complication in both groups. The retention rate of the Parasol plug was higher than the SuperEagle plug (44.4% and 24.1% respectively) (p = 0.012) and the retention rate of medium-sized plugs was higher than small-sized plugs (p = 0.027). Also, the plug retention rate decreased with age at 6 months (p = 0.032). Conclusions: Punctal occlusion with a silicone punctal plug was effective, regardless of the plug type or complication. The retention rate of the Parasol plug was higher than the SuperEagle plug.