Vardizer Y, Lang Y, Mourits M P, Briscoe M D
Department of Ophthalmology, Ha'emek Medical Center, Afula, Israel.
Orbit. 2007 Dec;26(4):263-6. doi: 10.1080/01676830600987557.
The use of punctal plugs in the treatment of dry eyes is well established. Anophthalmic patients have less tears in the anophthalmic socket in comparison to their normal side, due to an absent corneal reflex (Lee & Elsie, 1981a,b). Many of those patients complain of dry eye symptoms, even when they are treated with tear replacement therapy. The authors wished to examine whether they could improve their dry socket complaints with punctal plugs.
To evaluate the clinical efficacy and tolerability of punctal plug (Smart Plugs) insertion in anophthalmic patients with symptoms of dry eye.
Interventional case series. Fifteen anophthalmic patients with dry eye symptoms, a Schirmer test of less than 3 mm and an open lacrimal passage were examined before and after insertion of punctal plugs. The patients were asked for their subjective evaluation of the treatment and were examined to evaluate the change. Schirmer tests were compared. Bacterial cultures were taken at both visits.
Schirmer results of less than 3 mm in the anophthalmic socket were obtained in 75% of patients with dry eyes symptoms; 87% of patients in whom punctal plugs were inserted reported an improvement in dry eye sensation. More than half of the patients demonstrated less discharge (p < or = 0.05). Schirmer tests improved from 1.4 mm to 1.9 mm (p < or = 0.05). Patients with a Schirmer outcome of 2 mm or more tended to have less pathogenic bacterial cultures (p = 0.11).
Punctal plugs improve the symptoms and signs of dry socket. Punctal plugs seem to reduce the pathogenic bacterial growth in the anophthalmic socket.
泪点塞用于治疗干眼症已得到充分证实。与健侧相比，无眼球患者因角膜反射缺失，无眼球眼窝内泪液较少（Lee和Elsie，1981a，b）。即使接受泪液替代治疗，许多此类患者仍抱怨有干眼症状。作者希望研究泪点塞能否改善他们的眼窝干燥症状。
评估泪点塞（智能泪点塞）植入对有干眼症状的无眼球患者的临床疗效和耐受性。
干预性病例系列研究。对15例有干眼症状、泪液分泌试验小于3mm且泪道通畅的无眼球患者在植入泪点塞前后进行检查。询问患者对治疗的主观评价，并进行检查以评估变化情况。比较泪液分泌试验结果。两次就诊时均进行细菌培养。
75%有干眼症状的患者无眼球眼窝泪液分泌试验结果小于3mm；87%植入泪点塞的患者报告干眼感觉有所改善。超过半数患者分泌物减少（p≤0.05）。泪液分泌试验结果从1.4mm改善至1.9mm（p≤0.05）。泪液分泌试验结果为2mm或更高的患者致病细菌培养往往较少（p = 0.11）。
泪点塞可改善眼窝干燥的症状和体征。泪点塞似乎可减少无眼球眼窝内致病细菌的生长。
