Punctal and canalicular plugs: Indications, efficacy and safety

A-L Best; M Labetoulle; M Legrand; M M'garrech; E Barreau; A Rousseau

doi:10.1016/j.jfo.2018.12.003

Punctal and canalicular plugs: Indications, efficacy and safety

J Fr Ophtalmol. 2019 Mar;42(3):e95-e104. doi: 10.1016/j.jfo.2018.12.003. Epub 2019 Jan 26.

Authors

A-L Best¹, M Labetoulle², M Legrand¹, M M'garrech¹, E Barreau¹, A Rousseau³

Affiliations

¹ Ophthalmology Service, Hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, Université Paris-Sud, Division of Vision and Disabilities, OPHTARA rare eye disease, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France.
² Ophthalmology Service, Hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, Université Paris-Sud, Division of Vision and Disabilities, OPHTARA rare eye disease, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Viral and autoimmune disease immunology (IMVA/Infrastructure IDMIT) UMR 1184, CEA, 92260 Fontenay-aux-Roses, France.
³ Ophthalmology Service, Hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, Université Paris-Sud, Division of Vision and Disabilities, OPHTARA rare eye disease, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Viral and autoimmune disease immunology (IMVA/Infrastructure IDMIT) UMR 1184, CEA, 92260 Fontenay-aux-Roses, France. Electronic address: antoine.rousseau@aphp.fr.

PMID: 30692031
DOI: 10.1016/j.jfo.2018.12.003

Abstract

Lacrimal occlusion with punctal or canalicular plugs have been used to treat dry eye disease for more than 40 years. Indeed, punctal plugs constitute a safe and effective tool to retain the natural tear film and prolong the effect of tear substitutes. A wide variety of plugs is available, differing in their design, location (punctal versus canalicular) and their resorbability. There indications have increasingly broadened, and they are now one of the treatment options for numerous ocular surface diseases. Current research focuses on using punctal plugs for extended delivery of drugs to the ocular surface. This review addresses physiology of lacrimal drainage, available models of punctal plugs, their indications, practical details of prescribing and placing punctal and canalicular plugs, and possible complications.

Keywords: Canaliculitis; Dry eye; Intracanalicular plug; Lacrimal apparatus; Punctal plug.

Publication types

Review

MeSH terms

Dry Eye Syndromes / therapy*
Humans
Lacrimal Apparatus* / surgery
Prosthesis Implantation / adverse effects
Prosthesis Implantation / methods
Punctal Plugs* / adverse effects
Silicone Elastomers / adverse effects
Therapeutic Occlusion* / adverse effects
Therapeutic Occlusion* / instrumentation
Therapeutic Occlusion* / methods
Treatment Outcome

Substances

Silicone Elastomers