Abstract
Purpose: :
To evaluate the changes in the upper and lower tear menisci in dry eye following punctal occlusion.
Methods: :
Punctal occlusion with collagen plugs was performed on twenty normal subjects and twenty dry eye subjects. The upper and lower puncta of one eye of each subject were occluded. Real-time corneal optical coherence tomography (OCT) was used to image the upper and lower tear menisci simultaneously. Custom software was used to process OCT images to yield all variables. These included the radius of upper tear meniscus curvature (UTMR), height (UTMH), and cross-sectional area (UTMA) and the radius of lower tear meniscus curvature (LTMC), height (LTMH), and cross-sectional area (LTMA). The tests were performed at days 0, 1, 4, 7,and 10 after punctal occlusion. Repeated measurement analysis of variance (ANOVA) was used to analyze the changes in the tear menisci.
Results: :
In normal subjects, UTMR, UTMH, and UTMA did not show a significant change ( P =.535, P =.927, P =.857) following the occlusion of upper and lower puncta. Nor did LTMR, LTMH ,and LTMA ( P =.076, P =.296, P =.506 ). However, in dry eye subjects, UTMR, UTMH, and UTMA increased (P <.001, P <.001, P =.001) after the occlusion of upper and lower puncta. So did LTMR, LTMH, and LTMA (P =.010, P =.001, P =.026 ) .
Conclusions: :
Punctal occlusion in dry eye subjects increased both the upper and the lower tear menisci. OCT is a promising tool for studying the impact of punctal occlusion on tear dynamics.
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • cornea: tears/tear film/dry eye