Abstract
Purpose: :
To compare the efficacy of collagen and silicone plugs for treating dry eye using quantitative lacrimal scintigraphy.
Methods: :
Twenty–four dry eye patients were evaluated in two groups: Group I (n=22 eyes) received collagen plugs and Group II (n=26 eyes) received silicone plugs. Comparisons were made with controls (n=22 eyes) who had no ocular disorders. Data for the Schirmer–1 test, tear break–up time, and ocular surface staining with Rose Bengal dye were recorded before and after punctal occlusion. Lacrimal scintigraphy was performed at each time point, the time to half maximum activity on the ocular surface (T1/2), the percentage retention of activity on the ocular surface at the end of the dynamic study (RI) were recorded.
Results: :
In both patient groups, Schirmer–1 results, tear break–up time and Rose Bengal staining scores improved significantly after plug insertion. The group values for these parameters after plug placement were similar. The mean T1/2 value in the control group was 4.22±1.26 min. Before plug insertion, the mean T1/2 values in Groups I and II were 14.50±6.24 min. and 15.64±6.30 min., respectively. After insertion, the corresponding values were 24.50±8.00 min. and 24.43±7.66 min. (p<0.0001 for both). Prior to plug insertion, the mean RI values in Groups I and II were 45.35±19.39% and 44.5±16.75%, respectively. After insertion, the corresponding values were 68.64±12.77% and 62.12 ±17.86%, indicating significant increase in both groups (p<0.0001).
Conclusions: :
The collagen and silicone plugs both resulted in significant increases in aqueous tear volume, half–life of nuclear material on the ocular surface, and percentage of nuclear material retention. The groups’ post–insertion values for all parameters were similar. The results suggest that these two plug types have similar efficacy as treatments for dry eye in the short term.
Keywords: cornea: tears/tear film/dry eye • cornea: clinical science • lacrimal gland