Induced epiphora via punctal plugs can improve both subjective and objective measures in patients with refractory dry eye disease (DED), offering a potential adjunctive option for those unresponsive to conventional treatments, according to a study.
A recent 24-week randomized, sham-controlled trial examined the effects of induced epiphora using punctal plugs in patients (N = 66) with refractory DED and ocular surface damage. The treatment group received silicone punctal plugs in both upper and lower eyelids to promote tear overflow and the control group underwent a sham procedure.
The treatment group experienced significant improvements in both the Ocular Surface Disease Index (OSDI) and SICCA corneal staining scores compared with controls, with benefits appearing as early as 3 weeks and continuing throughout the study period. By 12 and 24 weeks, 70% of treated patients had OSDI scores in the mild or lower range.
Complications were noted, including plug dislodgement in 39.4% of patients and skin irritation in 33.3%, but over 90% reported satisfaction with the therapy.
Reference
Ahn H, Chung JL, Jun I, et al. Clinical efficacy of induced epiphora by punctal plugging on refractory dry eye disease with ocular surface Damage: Randomized sham-controlled trial. Cont Lens Anterior Eye. 2025;49(1):102588. doi: 10.1016/j.clae.2025.102588. Epub ahead of print. PMID: 41330011.
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