Optical Coherence Tomography Evaluation of the Effect of Punctal Plug Insertion on Tear Meniscus

The authors have no financial interest in the subject matter of this

e-poster.

Thomas John, MD1

Alissa Pullos

1- Loyola University at Chicago

Purpose: To report the findings of the change in tear meniscus area and tear volume as measured by optical coherence tomography (OCT) before and after the insertion of punctal plugs into the inferior punctum of patients diagnosed with dry eye syndrome.

Methods: Patients diagnosed with dry eye syndrome were

treated with the insertion of punctal plugs in the inferior punctum. There were 40 eyes of 20 patients in this study. Patients had dry eye syndrome evaluated in this study ( n = 20 eyes, 10 patients), while the other half consisted of normal controls ( n = 20 eyes, 10 patients) without dry eye syndrome. In the dry eye group, OCT images of the inferior tear meniscus were captured prior to the procedure, and again one and two weeks after the procedure. Four images were captured per eye during each session. Three sets of OCT images for the control group were captured, each one week apart. Software was used to calculate the area of the tear meniscus in each image.

Results: One week following punctal plug treatment for dry eye

syndrome, there was significant increase in the area of inferior tear meniscus. This increase continued two weeks following insertion of punctal plugs into the inferior punctum. Statistical analysis indicated a difference in the area of the inferior tear meniscus prior to treatment (M = 0.047, SD = 0.04) compared to one week following treatment (M = 0.12, SD = 0.15) (p<0.001). Statistical analysis also supports a significant increase in the area of the inferior tear meniscus, as compared to one week following the procedure (M = 0.12, SD = 0.15) (p<0.001). At two weeks following the procedure (M = 0.17, SD = 0.15 ) (p<0.001).

Conclusions: The implantation of punctal plugs into the inferior punctum proved to be an effective treatment for dry eye syndrome. This treatment had a beneficial effect in dry eye syndrome by blocking tear drainage and increasing tear retention.

Patient 1, Pre-plug

Patient 1, 1 Week post-plug

Patient 1, 2 Weeks Post-Plug

Table 1: Tear meniscus values before, during, and after insertion of punctal plugs into the inferior punctum and control values

Table 2: Paired T-Test Results