Punctal occlusion with Prolene suture material in the patients with dry eye

Abstract

Aim: To analyze the efficacy and outcomes of punctal occlusion with 5-0 Prolene suture material for the treatment of dry eye. Materials and

Methods: A total of 20 patients with moderate and severe dry eyes, recalcitrant to maximal medical therapy, underwent temporary punctal occlusion with 5-0 Prolene suture material. The lower punctum was dilated with a punctum dilator. Prolene suture pieces with sizes ranging from 1.5 to 2mm were made. A total of 8–10 such pieces were inserted into the lower punctum. The patients were followed up on the 1^st, 3^rd and 6^th months, and their values of Schirmer’s test, Teat film break up time and ocular surface staining were compared with the baseline values, which were taken as control.

Results: Punctal occlusion has been shown to improve the objective and subjective measures of dry eye. The patients obtained significant relief from the symptoms of dry eye by the end of 2 months. Recurrence of symptoms was noted at 6 months. Statistically significant difference was noted in the Schirmer’s and TBUT values between the baseline and at the end of the 3^rd and 6^th months. However, this difference was less than that at the end of the 1^st month. The corneal surface staining was improved at the end of the 1^st month, but it again began to deteriorate by the end of the 6^th month.

Conclusion: Prolene is a biologically inert, efficacious and cheaper alternative to collagen punctal plug. Occlusion of the puctum with a temporary punctal plug such as a Prolene suture material helps an ophthalmologist to plan for permanent punctal occlusion. Improvement in the eye condition after the use of temporary punctal occlusion suggests that the patient may benefit from permanent punctal occlusion.

Keywords: Dry eyes, prolene suture, punctal occlusion, punctal plug