Punctal plugs in the management of dry eyes.

ABSTRACT

Punctal plugs appear to be a relatively safe, effective, and reversible method of preserving aqueous and artificial tears on the ocular surface to reduce the signs and symptoms of dry eye. An absorbable plug may be used temporarily to assess the effectiveness of this therapy prior to insertion of a longterm nonabsorbable plug (Freeman-type, Herrick Lacrimal Plug, or SmartPlug) or cautery. Indications and contraindications for use of punctal plugs are discussed, as are features of various plugs, techniques of insertion and removal, complications, and outcomes.