Clinical efficacy of OASIS Preloaded Punctal Plug in Comparison to Smart Plug Punctal Plug in Aqueous-Deficient Dry Eye Disease

BackgroundAt present, there are few clinical studies comparing OASIS preloaded punctal plug and Smart Plug punctal plug for dry eye. This study intends to evaluate the effect of OASIS preloaded punctal plug versus Smart Plug punctal plug in the treatment of aqueous-deficient Dry Eye. Methods47 patients with aqueous-deficient dry eye were selected and randomly divided into control group and experimental group. The control group was treated with Smart Plug punctal plug treatment, and the experimental group was treated with OASIS preloaded punctal plug treatment. The OSDI questionnaire score, Schirmer I test and BUT results before and after treatment, and the incidences of postoperative complications were compared between the two groups. Follow up for six months. ResultsThe results of this study showed that compared with before treatment, the OSDI scores of patients were significantly improved at 6 months after treatment in both the experimental group and control group. After treatment, there was no significant difference in OSDI score, Schirmer I test, and BUT level between the two groups. Besides, the Smart Plug punctal plug treatment group had a significant improvement in BUT at 3 months after operation compared with before treatment. ConclusionThe OASIS preloaded punctal plug is comparable to the Smart Plug punctal plug in treating aqueous-deficient dry eye, and both can significantly improve dry eye symptoms. Furthermore, the OASIS preloaded punctal plug can facilitate intraoperative procedures, lacrimal punctum expansion and plug implantation can be completed in one step, and the loss of embolization before implantation and the abnormal implantation due to the expansion of the embolic volume can be reduced, which is worthy of clinical application.Clinical registration number: researchregistry6629; Registered 4 March 2021 - Retrospectively registered

Punctal occlusion for dry eye syndrome: summary of a Cochrane systematic review

Dry eye disease is a disorder of the tear film associated with ocular signs and symptoms. Punctal occlusion aids the preservation of natural tears. We conducted a Cochrane systematic review to assess the effectiveness of punctal plugs for managing dry eye. Randomised and quasi-randomised trials were included. The primary outcome was symptomatic improvement (SI) at 2–12 months. Nine databases were searched with no date or language restrictions. Two authors assessed trial quality and extracted data. Summary risk ratios and mean differences were calculated. Ten trials were included. In two trials of punctal plugs versus observation, there was less dryness with punctal plugs. The mean difference (MD) in the dry eye symptom score at 2 months was −28.20 points (95% CI –33.61 to −22.79, range 0 to 105, one trial). Three trials compared punctal plugs with artificial tears. In a pooled analysis of two trials, punctal plug participants reported more SI at 3 months than artificial tear participants (MD −4.20 points, 95% CI −5.87 to −2.53, scales varied from 0 to 6). In the remaining five trials comparing punctal plug placement, acrylic and silicone plugs, or comparing plugs with cyclosporine or pilocarpine, none of the investigators reported a clinically or statistically meaningful difference in symptomatic improvement at 2–12 months. The effectiveness of punctal plugs for treating dry eye symptoms and common signs are inconclusive. Heterogeneity in the type of punctal plug, type and severity of dry eye being treated, and trial methodology confounds the ability to make decisive statements regarding the effectiveness of punctal plugs.