Gelatt K N, MacKay E O, Widenhouse C, Widenhouse T S, Stopek J B
Department of Small Animal Clinical Sciences, University of Florida, Gainesville, and Veterinary Medical Solutions, Pembroke Pines, FL, USA.
Vet Ophthalmol. 2006 Jan-Feb;9(1):23-7. doi: 10.1111/j.1463-5224.2005.00430.x.
To evaluate effects of lacrimal punctal plugs positioned in either the upper, lower, or combination of upper and lower lacrimal canaliculi on plug retention and tolerance; tear production, as measured by the Schirmer tear test; and the dilution of fluorescein within the tear film in normal dogs.
Lacrimal punctal plugs were positioned in the lower, upper, or combination of lower and upper plugs in six laboratory-quality Beagles under topical anesthesia. Retention of plugs was evaluated daily from 8 to 23 days by visual inspection and slit-lamp biomicroscopy. Schirmer tear tests (STT 1 without topical anesthesia) were performed at 48-h intervals. Dilution of fluorescein was determined at 5- and 45-min post-fluorescein instillations once weekly.
Lacrimal punctal plugs of 0.4 and 0.6 mm in diameter were retained for 14 (lower plugs: 100%) and 23 days (75%), and for the upper plugs at 8 days less often (75%), and were infrequently locally nonirritating. Combination of lower and upper plugs seemed to adversely affect retention of either plug. When loss of the plugs occurred, a next larger size plug was necessary suggesting some stretching of the lacrimal canaliculi occurred. Pre- and postplug placement STT results indicated no change with lower and combination lacrimal punctal plugs, but decreased levels following upper lacrimal punctal plugs. Tear fluorescein levels at 5 and 45 min in control eye (no punctum plugs) were 3.39% and 0.14%, respectively. With lower, upper, and the combination of lower and upper lacrimal puncta plugs, tear fluorescein levels at 45 min were higher than the controls (lower: 0.76%; upper: 0.45%, and combination 0.56%).
Lacrimal punctal silicone plugs are retained for 8-23 days in the lower, upper, and combined lower and upper canaliculi at high rates. Effects on STT levels appear limited. Fluorescein within the tear film persists longer with all different positioned lacrimal punctum plugs than in the control eyes.
评估置于上泪小管、下泪小管或上下泪小管联合处的泪点塞对塞子保留率和耐受性的影响；通过泪液分泌试验测量泪液生成情况；以及正常犬泪膜中荧光素的稀释情况。
在局部麻醉下，将泪点塞置于6只实验级别的比格犬的下泪小管、上泪小管或上下泪小管联合处。从第8天至第23天，每天通过肉眼检查和裂隙灯生物显微镜检查评估塞子的保留情况。每隔48小时进行一次泪液分泌试验（不使用局部麻醉的STT 1）。每周一次，在滴入荧光素后5分钟和45分钟测定荧光素的稀释情况。
直径为0.4毫米和0.6毫米的泪点塞分别保留了14天（下泪小管塞：100%）和23天（75%），而上泪小管塞在8天时保留率较低（75%），且很少局部无刺激。上下泪小管塞联合使用似乎会对任一塞子的保留产生不利影响。当塞子脱落时，需要更换更大尺寸的塞子，这表明泪小管发生了一定程度的扩张。放置泪点塞前后的泪液分泌试验结果表明，下泪小管塞和联合使用泪点塞时无变化，但上泪小管塞放置后水平降低。对照眼（无泪点塞）在5分钟和45分钟时的泪液荧光素水平分别为3.39%和0.14%。使用下泪小管塞、上泪小管塞以及上下泪小管塞联合使用时，45分钟时的泪液荧光素水平高于对照眼（下泪小管塞：0.76%；上泪小管塞：0.45%，联合使用：0.56%）。
泪点硅胶塞在上、下泪小管及上下泪小管联合处的保留率较高，可保留8 - 23天。对泪液分泌试验水平的影响似乎有限。与对照眼相比，所有不同位置的泪点塞均可使泪膜中的荧光素持续更长时间。
